Adjuvant therapy by hyperbaric oxygen for high-energy lower limb fractures: a randomized controlled trial
10.3760/cma.j.cn115530-20241226-00508
- VernacularTitle:高压氧辅助治疗高能量下肢骨折的随机对照研究
- Author:
Xiongfei WANG
1
;
Yajuan LI
;
Wenshuo DONG
;
Liang LIU
;
Yakui ZHANG
;
Anhua LONG
Author Information
1. 首都医科大学附属北京潞河医院骨中心，北京 101100
- Publication Type:Journal Article
- Keywords:
Bones of lower extremity;
Fractures, bone;
Hyperbaric oxygenation;
Randomized controlled trial;
High-energy injuries;
Wound complications
- From:
Chinese Journal of Orthopaedic Trauma
2025;27(3):222-227
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effects of adjuvant therapy by hyperbaric oxygen for high-energy lower limb fractures.Methods:This prospective case-control study enrolled the patients with high-energy lower extremity fracture who had been admitted to Department of Orthopaedics, Beijing Luhe Hospital, Capital Medical University from January 2021 to December 2022. Their fracture types included tibial plateau ones, pilon ones, ankle ones complicated with dislocation, and calcaneal ones. The patients were randomly divided into a control group receiving routine orthopedic treatment and a trial group receiving adjuvant therapy by hyperbaric oxygen in addition to routine orthopedic treatment using a random number table. The first adjuvant therapy by hyperbaric oxygen was conducted in the trial group within 48 h after injury before the timing for surgery was decided according to the soft tissue swelling at the affected limb. Follow-up was conducted until one year after surgery. The early and late wound complications, time from injury to surgery, and hospital stay were compared between the 2 groups.Results:A total of 160 patients with high-energy lower extremity fracture were enrolled in this study. Eventually, 7 patients were excluded, 72 patients [48 males and 24 females, with an age of (46.3±12.5) years] included in the trial group and 81 patients [61 males and 20 females, with an age of (47.8±13.4) years] in the control group. There was no significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). The incidence of early wound complications in the trial group was 5.6% (4/72), significantly lower than that in the control group [18.5% (15/81)] ( P<0.05). The incidences of late wound complications in the trial and control groups were 12.5% (9/72) and 9.9% (8/81) respectively, showing no statistically significant difference ( P>0.05). The time from admission to surgery was respectively 4 (2, 8) days and 4 (2, 6) days, and the hospital stay respectively 10 (7, 14) days and 9 (6, 12) days for the trial and control groups, showing no statistically significant differences between the 2 groups ( P>0.05). Conclusion:In the treatment of high-energy lower extremity fractures, adjuvant therapy by hyperbaric oxygen can reduce the incidence of early wound complications without increasing the hospital stay, but it does not reduce the incidence of late wound complications or shorten the preoperative waiting time.
