[Annlication of external fixator combined with damage control treatment for open fracture of the extremities].
OBJECTIVE
To investigate the application and effects of external fixator under the guidance of damage control therapy in limb open fracture.


METHODS
From May 2008 to January 2013,72 cases with severe limb open fractures (Unincor- porated shock) were divided into control group and observation group (36 cases in each group). In observation group, 36 patients (including 22 males and 14 females) were treated by external fixator at stage I, as soon as possible after waiting for patients physiology conditions being stable,the stage II fracture operation was performed. In control group, 36 patients (24 males and 12 females) were treated by the first stage open reduction. The hospital admission time, open fracture severity score (OFSS),operation duration,operative blood loss,X-ray expose times, callus appear time, fracture healing time, postoperative infection rate, complications and Johner-Wruhs accceccment were recorded and evaluated.


RESULTS
All patients were followed up for 8 to 12 months (10.4 in averaged). The mean operation duration, operative blood loss, callus appear time, fracture healing time the mean operation duration reespectively were (56.79±8.87) min, (216.16±18.21) ml, (5.32±0.71) weeks, (12.79±2.52) weeks in observation group,and (104.53±9.28) min, (439.93±14.65) ml, (4.97±1.26) weeks, (14.81±2.63) weeks in control group. According to Johner-Wruhs acccecement,there were were 33 cases in excellent,2 in good,and 1 in poor in observation group,non-union of fracture in 1 case,local infection occurred in 1 cases; in control group 25 cases in excellent,6 in good, and 5 in poor, non-union of fracture in 1 case,local infection occurred in 8 cases. There were significant differences in operation duration, operative blood loss, callus appear time, fracture healing time, postoperative infection rate, complications (P<0.05). There were no significant differences in hospital admission time, open fracture severity score and X-ray expose times (P>0.05).


CONCLUSIONS
Under the guidance of damage control therapy,using external fixator measures to treat patients with open fractures of limbs is worth popularizing in clinical application because it can shorten the operation time, less blood loss, reduce the infection rate and complications, improve the success rate of surgery and recovery rate.
Shun-dong
SD
Li
Chao
C
Xu
Pei-jian
PJ
Tong
D000328:Adult; D000368:Aged; D016267:External Fixators; D005121:Extremities / Q000293:injuries* / Q000601:surgery; D005260:Female; D017102:Fracture Healing; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology