跟骨骨折切开复位内固定不同手术时机与术后软组织并发症的关系  

Relationship between postoperative complications of soft tissue and different operation time of incision reduction combined with internal fixation operation in patients with calcaneus fracture

作　　者：尚博[1] 

机构地区：[1]山东省临清市聊城市第二人民医院骨科,山东临清252600

出　　处：《实用临床医药杂志》2014年第19期66-69,共4页Journal of Clinical Medicine in Practice

摘　　要：目的观察和分析跟骨骨折切开复位内固定不同手术时机与术后软组织并发症的关系。方法选取2009年6月—2013年11月本院收治的高处坠落致跟骨闭合性骨折行切开复位钢板内固定患者141例（160侧）作为观察对象,根据患者术前准备时间将其分为A组（伤后3-8h实施手术,共纳入23侧）、B组（伤后8-3d实施手术,共纳入30侧）、C组（伤后4-7d实施手术,共纳入48侧）和D组（伤后7-14d实施手术,共纳入59侧）。对患者发生术后切口并发症的情况及年龄、性别、手术时间、植骨种类、坠落高度等进行回顾性分析。结果本组病例中有60侧骨折术后发生切口并发症,发生率为37.5%;发生切口并发症的病例与未发生切口并发症的病例在坠落高度、止血带使用时间、手术时间等方面的差异有统计学意义（P〈0.05）;A组和D组术后切口并发症发生率差异无统计学意义（P〉0.05）,B组和C组术后切口并发症发生率的差异无统计学意义（P〉0.05）,A组或D组术后切口并发症的发生率显著低于B组或C组（P〈0.05）。结论切口并发症仍然是跟骨骨折切开复位内固定术后的主要并发症,其发生率与骨折的类型无关,坠落高度、止血带使用时间、手术时间可能是切口并发症发生的危险因素,选择在骨折后8h内或7-14d行切开复位固定术能够降低术后切口并发症的发病率。Objectives To observe and analyze the relationship between thepostoperative complications soft tissue and the different operation time of incision reduction combined with internal fixation operation in the patients with calcaneus fracture.Methods 141patients（160sides）with calcaneus fracture treated with incision reduction combined with internal fixation operation were selected and divided into group A（operations were implemented during 3to 8hours after the injury,23 sides included）,group B（operations were implemented during8 hours to 3days after the injury,30 sides included）,group C（operations were implemented during 4to 7days after the injury,48 sides included）and group D（operations were implemented during 7to 14 days after the injury,59 sides included）according to the patients′preoperative preparation time.The postoperative wound complications and age,gender,operation time,bone graft type,the falling height of the patients were analyzed retrospectively.Results The postoperative incision complications were observed in 60 sides of the fractures in this group and the incidence rate was 37.5%.There were significant differences of the falling height,tourniquet time and operation time between the sides with incision complications and without incision complications（P〈0.05）.The difference of the incidences of postoperative incision complications between group A and group D showed no significant diversity（P〉0.05）,and the difference of the incidence rate of postoperative incision complications between group B and group C showed no significant diversity（P〉0.05）.The incidence of incision complications of group A or group D was significantly lower than that of group B or group C（P〈0.05）.Conclusion The incision complications are still the main complications after incision reduction combined with internal fixation operation for calcaneus fractures.The complications rate is independent with the fracture type rate and the falling height,tourniquet time,operation time may be the risk

关 键 词：跟骨骨折 切开复位内固定术 术后切口并发症 手术时机 

分 类 号：R683[医药卫生—骨科学]