Severe open fracture
Conditions
Interventions
control group:The control group underwent routine one-stage treatment, which included thorough debridement, fixation of fractures with external fixation braces, and coverage of the wound with VSD. In
Orthoplastic group:The orthopedic team will complete thorough debridement in the first stage, followed by minimally invasive percutaneous plate osteosynthesis or intramedullary nailing for fracture fi
Orthoplastic+ERAS group:After admission, the patient received preoperative education and psychological counseling under the ERAS concept, and received multimodal analgesia to increase patient comfort.
Sponsors
Zhuzhou central hospital
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1 Gustilo type IIIB and C fractures (wound >10cm, extensive soft tissue loss with or without vascular injury requiring repair, extensive periosteal detachment, poor fracture coverage, heavy wound contamination, requiring wound repair); 2 All cases were diagnosed through imaging examinations such as X-ray and CT; 3 Patients with fresh fractures (fractures occurred within 6 hours); 4 Individuals without other infectious diseases; 5 Individuals with no history of mental illness and normal cognitive abilities; 6 Those who voluntarily participate and sign the informed consent form, and are able to cooperate and complete the entire trial process.
Exclusion criteria
Exclusion criteria: 1 Patients with closed fractures and pathological fractures; 2 Patients with severe multiple injuries (ISS = 16 points); 3 Patients with hepatic and renal insufficiency, and abnormal coagulation function; 4 Patients with malignant tumors; 5 Patients with severe underlying diseases; 6 Those who have undergone surgery on the affected limb.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| X-ray and CT scans show the healing status of bones;Knee joint function score (HSS), ankle joint Kofoed score, and Johner-Wruhs score; | — |
Secondary
| Measure | Time frame |
|---|---|
| Wound healing area and wound healing quality;Number and positivity rate of pathogenic bacteria infection, levels of inflammatory factors (C-reactive protein, white blood cell count, interleukin-6, tumor necrosis factor alpha, and erythrocyte sedimentation rate); | — |
Countries
China
Contacts
Public ContactEryue Qiu
Zhuzhou central hospital
Outcome results
None listed