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Abstract：
Background Open fractures associated with significant tissue loss are complex and present challenges in management; they are associated with poor outcomes such as infection, non-union or amputation. This study aimed to evaluate outcomes of using an adjuvant local antibiotic hydroxyapatite bio-composite in the management of open Gustilo-Anderson IIIB fractures with up to eight years of follow-up. Methods This was a retrospective study. A total of 81 patients with Gustilo-Anderson IIIB fractures treated with \"fix and flap\" limb reconstruction with adjuvant local antibiotic therapy using a bio-composite carrier were reviewed. Results The mean follow-up time for all the patients, at the time of data collection, was 55.8 months. Union was achieved in 96% with a limb salvage rate of 96.3% and a deep infection rate of 3.7%. Conclusion The use of local antibiotic therapy, together with a combined orthoplastic \"fix and flap\" approach for Gustilo-Anderson IIIB open fractures, was found to be associated with a very low rate of metalwork infection and high union and limb salvage rates. Future studies should include some functional and quality of life outcome measures to see the efficacy of this method.
摘要：
背景与大量组织丢失相关的开放性骨折是复杂的，并且在管理方面存在挑战；它们与不良预后相关，例如感染，不愈合或截肢。这项研究旨在评估使用辅助局部抗生素羟基磷灰石生物复合材料治疗Gustilo-AndersonIIIB开放性骨折的结果，并进行长达8年的随访。方法回顾性研究。对81例Gustilo-AndersonIIIB骨折患者进行了“固定和皮瓣”肢体重建，并使用生物复合载体进行了辅助局部抗生素治疗。结果所有患者的平均随访时间,在收集数据的时候，55.8个月。以96％的比例实现了联合，保肢率为96.3％，深部感染率为3.7％。结论使用局部抗生素治疗,结合“固定和皮瓣”方法治疗Gustilo-AndersonIIIB开放性骨折，被发现与非常低的金属制品感染率以及高的愈合和肢体抢救率有关。未来的研究应该包括一些功能和生活质量结果测量，以观察这种方法的有效性。
