Clinical application of nose ring drain technique combined with Ilizarov circular external fixation for Gustilo ⅢA Pilon fractures_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

PU Shaoquan ¹ , XU Yongqing ¹ , LÜ Qian ¹ , LIU Zhineng ² , ZHAO Yonghui ¹ , ZHAO Zeyu ¹ , XIA Shen ¹ , QI Xin ¹ , QU Long ³ ,  ZHU Yueliang ¹

1. Department of Orthopaedics, the 920th Hospital of Joint Logistics Support Force, Kunming Yunnan, 650032, P.R.China;
2. Department of Orthopedics, People’s Hospital of Dongchuan District of Kunming, Kunming Yunnan, 654100, P.R.China;
3. Department of Orthopedics, Aerospace 731 Hospital, Beijing, 100074, P.R.China;

Corresponding author：

ZHU Yueliang, Email: 416197429@qq.com

Keywords：

Pilon fracture; Gustilo Ⅲ A fracture; nose ring drain technique; Ilizarov technique; circular external fixation

DOI：

10.7507/1002-1892.202009101

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the effectiveness of the nose ring drain (NRD) technique combined with Ilizarov circular external fixation in treatment of Gustilo ⅢA Pilon fracture.Methods Between March 2017 and December 2019, 17 patients with Gustilo ⅢA Pilon fractures were admitted and treated with NRD technique combined with Ilizarov circular external fixation. Among them, there were 11 males and 6 females; the age ranged from 24 to 63 years, with an average of 38.2 years. There were 3 cases of traffic accident injury, 13 cases of falling injury, and 1 case of penetrating injury. There were 13 cases of emergency admittance and 4 cases of wound infection after surgical treatment. Furthermore, there were 2 cases of fibula fractures and 3 cases of lateral malleolus fractures. Results All patients were followed up 8-12 months, with an average of 9.9 months. All wounds healed by first intention, and 4 patients with preoperative infection had no recurrence during the follow-up. The external fixator was removed after fracture healing in 17 patients at 3-7 months after operation (mean, 4.5 months). At last follow-up, the pain score of the ankle joint Kofoe score was 40-50, with an average of 44; the functional score was 17-27, with an average of 25; the mobility score was 8-18, with an average of 14; and the effectiveness was rated as excellent in 8 cases, good in 7 cases, and poor in 1 case.Conclusion For Gustilo ⅢA Pilon fractures, the NRD technique combined with Ilizarov circular external fixation has advantages of good fracture fixation and drainage effects, which greatly reduces the complications of traditional treatment options and the number of operations.

Citation： PU Shaoquan, XU Yongqing, LÜ Qian, LIU Zhineng, ZHAO Yonghui, ZHAO Zeyu, XIA Shen, QI Xin, QU Long, ZHU Yueliang. Clinical application of nose ring drain technique combined with Ilizarov circular external fixation for Gustilo ⅢA Pilon fractures. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(2): 195-199. doi: 10.7507/1002-1892.202009101 Copy

1.	Rammelt S, Endres T, Grass R, et al. The role of external fixation in acute ankle trauma. Foot Ankle Clin, 2004, 9(3): 455-474.
2.	Boraiah S, Kemp TJ, Erwteman A, et al. Outcome following open reduction and internal fixation of open pilon fractures. J Bone Joint Surg (Am), 2010, 92(2): 346-352.
3.	田林, 艾克拜尔·亚森, 谭玉忠, 等. 牛鼻子引流术在严重糖尿病足感染创面中的临床应用. 中国修复重建外科杂志, 2020, 34(8): 990-993.
4.	Solomin LN. Ilizarov 技术基本原理与应用. 2 版. 北京: 人民军医出版社, 2019: 81-85.
5.	McCann PA, Jackson M, Mitchell ST, et al. Complications of definitive open reduction and internal fixation of pilon fractures of the distal tibia. Int Orthop, 2011, 35(3): 413-418.
6.	Pollak AN, McCarthy ML, Bess RS, et al. Outcomes after treatment of high-energy tibial plafond fractures. J Bone Joint Surg (Am), 2003, 85(10): 1893-1900.
7.	Mehta S, Gardner MJ, Barei DP, et al. Reduction strategies through the anterolateral exposure for fixation of type B and C pilon fractures. J Orthop Trauma, 2011, 25(2): 116-122.
8.	Mafi P, Stanley J, Hindocha S, et al. Pilon fracture: a case report of a 45-year-old dental technician. Open Orthop J, 2014, 8: 433-436.
9.	李毅, 王虎, 梁晓军, 等. 分期手术治疗严重开放性踝关节骨折的疗效观察. 中国骨与关节损伤杂志, 2014, 29(2): 189-190.
10.	Huebner EJ, Iblher N, Kubosch DC, et al. Distal tibial fractures and pilon fractures. Acta Chir Orthop Traumatol Cech, 2014, 81(3): 167-176.
11.	Stillhard PF, Frima H, Sommer C. Pilon fractures-considerations for treatment strategies and surgical approaches. Oper Orthop Traumatol, 2018, 30(6): 435-456.
12.	齐欣, 徐永清, 夏燊, 等. 单纯 Ilizarov 环形外固定技术治疗合并骨筋膜室综合征的胫骨平台骨折. 中国修复重建外科杂志, 2020, 34(10): 1248-1252.
13.	闫秀中, 王燕, 王德志, 等. Ilizarov 环形外固定架治疗胫腓骨开放骨折的临床研究. 中国矫形外科杂志, 2017, 25(4): 321-324.
14.	马赫, 姚辉, 张涛, 等. Taylor 空间外固定架与单臂外固定架治疗胫腓骨开放骨折疗效比较. 中国修复重建外科杂志, 2020, 34(4): 447-451.
15.	Walter G, Kemmerer M, Kappler C, et al. Treatment algorithms for chronic osteomyelitis. Dtsch Arztebl Int, 2012, 109(14): 257-264.
16.	El-Sayed M, Atef A. Management of simple (types A and B) closed tibial shaft fractures using percutaneous lag-screw fixation and Ilizarov external fixation in adults. Int Orthop, 2012, 36(10): 2133-2138.
17.	Scherer SS, Pietramaggiori G, Mathews JC, et al. The mechanism of action of the vacuum-assisted closure device. Plast Reconstr Surg, 2008, 122(3): 786-797.
18.	Morykwas MJ, Simpson J, Punger K, et al. Vacuum-assisted closure: state of basic research and physiologic foundation. Plast Reconstr Surg, 2006, 117(7 Suppl): 121S-126S.
19.	王瑞国, 荆兆峰, 邵明伟. 持续冲洗 VSD 一期闭合创腔与单纯 VSD 治疗软组织坏死及感染的疗效比较. 中国骨与关节损伤杂志, 2016, 31(1): 100-101.
20.	宋健, 喻爱喜, 漆白文, 等. 负压封闭引流技术在难治性溃疡创面的应用. 中华显微外科杂志, 2016, 39(1): 102-104.
21.	曲龙. 骨搬移治疗骨缺损与骨不连—Ilizarov 技术的临床应用. 北京: 人民卫生出版社, 2009: 44-48.

1. Rammelt S, Endres T, Grass R, et al. The role of external fixation in acute ankle trauma. Foot Ankle Clin, 2004, 9(3): 455-474.
2. Boraiah S, Kemp TJ, Erwteman A, et al. Outcome following open reduction and internal fixation of open pilon fractures. J Bone Joint Surg (Am), 2010, 92(2): 346-352.
3. 田林, 艾克拜尔·亚森, 谭玉忠, 等. 牛鼻子引流术在严重糖尿病足感染创面中的临床应用. 中国修复重建外科杂志, 2020, 34(8): 990-993.
4. Solomin LN. Ilizarov 技术基本原理与应用. 2 版. 北京: 人民军医出版社, 2019: 81-85.
5. McCann PA, Jackson M, Mitchell ST, et al. Complications of definitive open reduction and internal fixation of pilon fractures of the distal tibia. Int Orthop, 2011, 35(3): 413-418.
6. Pollak AN, McCarthy ML, Bess RS, et al. Outcomes after treatment of high-energy tibial plafond fractures. J Bone Joint Surg (Am), 2003, 85(10): 1893-1900.
7. Mehta S, Gardner MJ, Barei DP, et al. Reduction strategies through the anterolateral exposure for fixation of type B and C pilon fractures. J Orthop Trauma, 2011, 25(2): 116-122.
8. Mafi P, Stanley J, Hindocha S, et al. Pilon fracture: a case report of a 45-year-old dental technician. Open Orthop J, 2014, 8: 433-436.
9. 李毅, 王虎, 梁晓军, 等. 分期手术治疗严重开放性踝关节骨折的疗效观察. 中国骨与关节损伤杂志, 2014, 29(2): 189-190.
10. Huebner EJ, Iblher N, Kubosch DC, et al. Distal tibial fractures and pilon fractures. Acta Chir Orthop Traumatol Cech, 2014, 81(3): 167-176.
11. Stillhard PF, Frima H, Sommer C. Pilon fractures-considerations for treatment strategies and surgical approaches. Oper Orthop Traumatol, 2018, 30(6): 435-456.
12. 齐欣, 徐永清, 夏燊, 等. 单纯 Ilizarov 环形外固定技术治疗合并骨筋膜室综合征的胫骨平台骨折. 中国修复重建外科杂志, 2020, 34(10): 1248-1252.
13. 闫秀中, 王燕, 王德志, 等. Ilizarov 环形外固定架治疗胫腓骨开放骨折的临床研究. 中国矫形外科杂志, 2017, 25(4): 321-324.
14. 马赫, 姚辉, 张涛, 等. Taylor 空间外固定架与单臂外固定架治疗胫腓骨开放骨折疗效比较. 中国修复重建外科杂志, 2020, 34(4): 447-451.
15. Walter G, Kemmerer M, Kappler C, et al. Treatment algorithms for chronic osteomyelitis. Dtsch Arztebl Int, 2012, 109(14): 257-264.
16. El-Sayed M, Atef A. Management of simple (types A and B) closed tibial shaft fractures using percutaneous lag-screw fixation and Ilizarov external fixation in adults. Int Orthop, 2012, 36(10): 2133-2138.
17. Scherer SS, Pietramaggiori G, Mathews JC, et al. The mechanism of action of the vacuum-assisted closure device. Plast Reconstr Surg, 2008, 122(3): 786-797.
18. Morykwas MJ, Simpson J, Punger K, et al. Vacuum-assisted closure: state of basic research and physiologic foundation. Plast Reconstr Surg, 2006, 117(7 Suppl): 121S-126S.
19. 王瑞国, 荆兆峰, 邵明伟. 持续冲洗 VSD 一期闭合创腔与单纯 VSD 治疗软组织坏死及感染的疗效比较. 中国骨与关节损伤杂志, 2016, 31(1): 100-101.
20. 宋健, 喻爱喜, 漆白文, 等. 负压封闭引流技术在难治性溃疡创面的应用. 中华显微外科杂志, 2016, 39(1): 102-104.
21. 曲龙. 骨搬移治疗骨缺损与骨不连—Ilizarov 技术的临床应用. 北京: 人民卫生出版社, 2009: 44-48.

Chinese Journal of Reparative and Reconstructive Surgery

Clinical application of nose ring drain technique combined with Ilizarov circular external fixation for Gustilo ⅢA Pilon fractures

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content