跟骨骨折术后切口不愈的原因分析  

Analysis on the causes of unhealed incision after the operation of calcaneal fracture

作　　者：唐一仑[1] 宋金辉[1] 党晓谦[1] 张晨[1] 

机构地区：[1]西安交通大学第二附属医院骨一科,陕西西安710004

出　　处：《中国医药科学》2013年第23期213-214,共2页China Medicine And Pharmacy

摘　　要：目的分析闭合性跟骨骨折切开复位内固定术后切口愈合不良的原因。方法 2009年5月~2013年5月间,我科有61例(78侧足)跟骨骨折患者行跟骨外侧L型切口,其中53例男性(67侧足),8例女性(11侧足),年龄21~57岁(平均39岁)。56例(71足)是高处坠落伤,5例(7足)是交通伤。手术时间为伤后3h^22d,平均9d。骨折根据Sanders分型,Ⅱ型34足,Ⅲ型31足,Ⅳ型13足。对这些患者的全身状况、手术时机、手术方法、内固定物的选择、手术后处理等情况进行回顾性分析,并对患者进行术后随访,随访0.5~3年,平均随访时间20个月。结果有7例患者(9侧足)发生切口边缘坏死或裂开,占11.5%。经相应治疗,均获得愈合。结论跟骨骨折术后切口愈合不良的发生与患者全身状况、合并的基础疾病、跟骨的解剖特点、手术的时机选择、内固定物的选择、手术操作及术后处理等多种因素相关。Objective To analyze the causes of poor wound healing after the open reduction and internal fixation of closed calcaneal fracture. Methods 61 patients（78 calcaneus） with calcaneal fracture were treated by using the L-shaped incision in lateral calcaneus in our department from May 2009 and May 2013, in which there were 53 males（67 calcaneus） and 8 females（11 calcaneus）, and the age ranged from 21 years to 57 years, the mean age was 39 years. There were 56 cases（71 calcaneus） caused by the falling and 5 cases（7 calcaneus） caused by the traffic accident. The operation time ranged from 3 hours to 22 days after the injury, and the mean operation time was 9 days. There were 34 calcaneus with type Ⅱ, 31 calcaneus with type Ⅲ, and 13 calcaneus with type Ⅳ according to the Sanders classification. The general condition,operation timing and method, internal fixation choice,treatment after surgery of patients were retrospectively analyzed, and the patients were followed up within 0.5 year to 3 years after surgery, the average follow-up time was 20 months. Results There were 7 patients（9 calcaneus） with incision edge necrosis or dehiscence, which accounted for 11.5% and obtained healing after the symptomatic treatment. Conclusion The incidence of poor wound healing after the operation of calcaneal fracture is associated with the general condition,com plications,anatomical features of calcaneus, operation timing choice,internal fixation choice, operative, postoperative treatment and other factors.

关 键 词：闭合性跟骨骨折 外侧“L”型切口 切口愈合不良 

分 类 号：R683.4[医药卫生—骨科学]