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 iliA in 10 cases, Type ⅢB in 7 and Type Ⅲ C 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 eases 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. Conclusion Gustilo type Ⅲ compound ankle fracture can effectively be treated with VSD and spanning external fixator. Key words: Ankle injuries; Fractures,open; External fixation; Vacuum sealing drainage; Transposition of flap