跟骨骨折内固定术后皮肤坏死原因及对策  

Causes and strategies of skin necrosis after open reduction and internal fixation of calcaneal fracture

作　　者：邓志成[1] 朱小华[1] 王小平[1] 许国泰[1] 郭胜[1] 

机构地区：[1]南方医科大学附属小榄医院骨二科,广东中山528415

出　　处：《海南医学》2013年第1期87-88,共2页Hainan Medical Journal

摘　　要：目的探讨跟骨骨折行外侧L型切口钢板内固定术后伤口皮肤延迟愈合、皮肤坏死的原因及对策。方法回顾分析我院骨科2006-2010年行外侧L型切口钢板内固定术的72例跟骨骨折患者术后伤口情况。结果本组72例均获平均4.5个月的随访,术后发生创口边缘皮肤坏死、创口感染导致创口不愈合7例,5例经换药后愈合。2例行腓肠神经营养皮瓣转移修复创面治疗痊愈。结论采取跟骨外侧L型切口行切开复位钢板内固定治疗跟骨关节内骨折时,熟练掌握跟骨周围解剖结构,把握手术时机、规范操作、充分引流、按皮瓣技术操作是避免后皮肤坏死的关键。Objective To explore the causes and strategies of skin necrosis and incision delayed union after open reduction and internal fixation （ORIF） by lateral L-shaped incision. Methods Seventy two patients of calcaneal fractures in our department from 2006 to 2010 with lateral incision were observed and discussed after open reduction and internal fixation （ORIF）. Results The patients were followed up for an average of 4.5 months. Skin incision edge partially necrosis or faulty union postoperation occurred in seven patients, of which five were cured by dressing and two were cured by skin island flap supplied by the nervus suralis. Conclusion For treating ealcaneal intraarticular fractures with ORIF through lateral L-shaped incision, the surgeons should know the regional anatomy around the calcaneos very well, choose the best operation timing, drain the wound properly and perform according to skin flap technique. These are the key points to avoid the skin flap necrosis.

关 键 词：跟骨骨折 内固定 切口 愈合 皮肤坏死 对策 

分 类 号：R683.42[医药卫生—骨科学]