2016 Volume 29 Issue 1 Pages 1-7
From 2000 to 2010 we treated 24 cases of the Gustilo typeIIIB/C open fracture of the tibia. There were 18 men and 6 women with an average age of 41.2 years ( 20 to 75 ). We divided these patients into four groups by the injury degree of bone and soft tissue. Group 1 comprised 17 patients who had a small bone defect and a large soft tissue defect. The soft tissue defects were treated with flap surgery ( 14 free and three regional ) and the bone defects with conventional bone grafts. Fourteen patients healed without any trouble, but three patients experienced deep infections and these were treated by bone transfer of tibio fibular synostosis. Group 2 comprised one patient who had the same size of bone and soft tissue defect and these defects were treated by distractive histiogenesis. The patient healed without any trouble. Group 3 comprised five patients who had a segmental bone defect ( 6cm> ) and a large soft tissue defect. The soft tissue defects were treated with free flap and the bone defects by Masquelet or vascularized bone grafts. They healed without any trouble. Group 4 was one patient who had a segmental bone defect ( 6cm< ) and a large soft tissue defect and was treated with vascularized fibula graft and peroneal flap. The patient healed without any trouble. If the soft tissue defects are treated appropriately during the acute phase, the VBG or Ilizarov methods are rarely indicated.
