[Surgical treatment of compound fracture of the ankle].
OBJECTIVE
To report the clinical outcome of the treatment of compound ankle fractures by vacuum sealing drainage and spanning external fixator.


METHODS
From April 2005 to April 2009, 19 cases of Gustilo type III compound ankle fractures were treated, with type IIIA in 10 cases, Type IIIB in 7 and Type IIIC in 2. All cases underwent emergency debridement, and had the fractures fixed with spanning external fixator following indirect reduction, the wound closed with vacuum sealing drainage and repaired through direct suture, split-thickness skin graft or flap transposition.


RESULTS
In this series, following VSD of 5.0 to 18.0 d (mean 10.3 d), 2 cases had their wounds closed by direct suture, 12 by skin graft and 3 by flap transposition. The other 2 cases had repeated wound debridement and multiple use of VSD, and had their wounds repaired by flap transposition. All the 19 cases were followed up for 8 to 36 months with an average of 26 months. All the fractures united 3.0 to 10.0 (mean 3.8) months. At the final follow-up functional evaluation of the affected ankle joints was performed only to find excellent in 9 cases, good in 5, fair in 4 and poor in 1.


CONCLUSIONS
Gustilo type III compound ankle fracture can effectively be treated with VSD and spanning external fixator.
Zhang
Li-hai
LH
Department of Orthopedics and Trauma Surgery, People's Liberation Army General Hospital, Beijing 100853, China.
Zhang
Li-cheng
LC
Chen
Hua
H
Liang
Xiang-dang
XD
Guo
Yi-zhu
YZ
Tao
Sheng
S
Zhang
Qun
Q
Tang
Pei-fu
PF
Wang
Yan
Y
D000328:Adult; D000368:Aged; D016512:Ankle Injuries / Q000601:surgery*; D016267:External Fixators; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods*; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D016896:Treatment Outcome; D055815:Young Adult