跟骨骨折钢板内固定手术中存在的问题及对策  

Problems and solutions of plate internal fixation for the treatment of calcaneal fractures

作　　者：校佰平[1] 李明[1] 王邦荣[1] 周龙[1] 俞怡辉[1] 王庆[1] 魏军渔[1] 

机构地区：[1]宁波市第六医院创伤骨科,浙江宁波315040

出　　处：《中国骨伤》2009年第12期897-898,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的:回顾性分析跟骨骨折钢板内固定手术治疗中的操作及结果,找出存在的问题并提出相应的对策,以减少手术并发症的发生。方法:2008年6月至2009年4月收治156例患者,男121例,女35例;年龄18～59岁,平均41岁。32例双跟骨骨折,其中23例同时行双跟骨手术治疗,手术治疗跟骨共179足。对所有患者的手术记录予以分析,以便发现存在的问题及不足。结果:179个跟骨骨折中,有31足(17.3%)术后伤口出现问题:伤口感染不愈合26足(14.5%),皮缘坏死5足(2.8%),伤口不愈合。跟骨骨折钢板内固定手术存在许多问题,从手术设计到具体操作,以及骨折复位和固定。结论:手术的改良、微创操作、简单而有效的内固定是避免跟骨骨折手术并发症的惟一途径。Objective：To retrospective analysis operating procedures and results of calcaneal fractures treated with plate fixation,identify problems and propose measures to reduce surgical complications.Methods：From June 2008 to April 2009,156 patients were reviewed,including 121 males and 35 females,ranging in age from 18 to 59 years,with an average of 41 years.Thirty two patients had bilateral calcaneal fractures.Twenty three patients were surgically treated on both calcaneus at the same time.Total 179 calcaneus were treated with operation.The operation records of all patients were analyzed in order to find the problems and deficiencies.Results：Among 179 calcaneal fractures,31 feet （17.3%）had postoperative wound problems：wound infection and non healing were found in 26 feet（14.5%）,skin flap necrosis in 5 feet（2.8%）.There were a lot of problems of plate internal fixation for the treatment of calcaneal fractures,including operation design,operative technique,as well as fracture reduction and fixation.Conclusion：The following methods are the only way to avoid operative complications for the treatment of calcaneal fractures：improved surgical technique,minimally invasive operation,simple and effective internal fixation.

关 键 词：跟骨 骨折 骨折固定术 内 外科手术 

分 类 号：R683.42[医药卫生—骨科学] R657.4[医药卫生—外科学]