跟骨骨折术后并发症的分析及预防策略  

Analysis of postoperative complications of calcaneal fractures and prevention strategies

作　　者：刘彦[1] 

机构地区：[1]暨南大学附属江门中医院,广东江门529031

出　　处：《四川医学》2012年第9期1593-1595,共3页Sichuan Medical Journal

摘　　要：目的探讨跟骨关节内骨折内固定手术并发症的原因、预防和策略。方法对77例82足跟骨关节内骨折进行了切开复位内固定治疗,围手术期常规应用抗生素预防感染,随访时间5～35个月,平均10个月。结果按照Mar-ryland足部评分系统(Marrryland Foot Score)评价术后功能,患足功能优27足,良42足,可13足。本组发生早期并发症16足,发生率为19.5%,其中切口边缘皮肤坏死9足,伤口感染4足,伤口排异反应2足,腓肠神经损伤1足。晚期出现距下关节慢性疼痛、明显影响行走6足,发生率为7%。结论跟骨关节内骨折内固定手术并发症与跟骨解剖特点、跟骨骨折机制、手术方式、手术切口的选择、复位效果以及固定方式有关,但可以通过有效的措施减少并发症的发生,出现并发症后可根据情况作出相应的处理。Objective To investigate the intra-articular calcaneal fracture fixation complications, causes, prevention and policy. Methods For intra-articular calcaneal fractures in 82 feet for an open reduction and internal fixation and treatment, rou- tine use of perioperative antibiotics to prevent infection, follow-up time of 5 to 35 months, an average of 10 months. Results In accordance with Marryland Foot Score were evaluated, the affected foot function fine 27 feet, good 42 feet, 13 feet. Early compli- cations occurred in this group of 16 feet, the rate was 19. 5%, of which 9 feet cut edge of skin necrosis, wound infection in 4 foot, 2 foot wound rejection, sural nerve injury in 1 foot. Later stage of the subtalar joint chronic pain, significantly affect walking 6 feet, the rate was 7%. Conclusion Intra-articular calcaneal fracture fixation complications and anatomical characteristics of the calcaneus and calcaneal fracture mechanisms, but through effective measures to reduce the incidence of complications, complica- tions after the treatment according to the situation accordingly.

关 键 词：跟骨骨折 内固定手术后 并发症 

分 类 号：R687.3[医药卫生—骨科学]