足跟部软组织剥脱伤合并跟骨骨折的手术治疗  

Surgery treatment of heel soft tissue denudation injury associated with calcaneal fractures

作　　者：黄恩铭 

机构地区：[1]淳安县第一人民医院骨科,浙江淳安311700

出　　处：《临床骨科杂志》2015年第3期367-368,共2页Journal of Clinical Orthopaedics

摘　　要：目的探讨足跟部软组织剥脱伤合并跟骨骨折的临床治疗方法及疗效。方法对16例足跟软组织剥脱伤合并跟骨骨折患者行一期清创、二期跟骨骨折切复钢板内固定加带抗生素人工骨植骨术。结果患者足跟部剥脱伤皮瓣均一期成活（其中有2例术后初期出现表皮部分坏死,经短期换药创面顺利愈合）。患者均获得随访,时间6~24个月。未并发慢性软组织感染、骨髓炎。骨折愈合时间为15~22周。末次随访AOFAS踝-后足功能评分：优6例,良8例,中2例。结论足跟软组织剥脱伤合并跟骨骨折,一期清创为二期骨折内固定提供良好的软组织条件,可取得满意疗效。Objective To investigate the treatment methods and clinical efficacy of heel soft tissue denudation injury associated with calcaneal fractures. Methods 16 cases of heel soft tissue denudation injury associated with calcaneal fractures were undergone surgery. Firstly,a thorough debridement were applied,secondly calcaneal fractures were treated with open reduction,plate fixation and bone graft complex with antibiotics. Results All soft tissue denudation injury flap survived,while skin necrosis occurred in two cases,but wounds healed by short-term of changing dressing. All patients were followed up from 6 months to 24 months,no chronic soft tissue infections and osteomyelitis.Fracture healing time was 15 ~ 22 weeks. The last follow-up for AOFAS ankle-hind foot functional scores： excellent in6 cases,good in 8,fair in 1. Conclusions For the heel soft tissue denudation injury associated with calcaneal fractures,thorough firstly debridement can provide good soft tissue conditions for the second phase fracture fixation,which can achieve satisfactory effect.

关 键 词：软组织剥脱伤 跟骨骨折 骨折固定术 植骨 

分 类 号：R683.42[医药卫生—骨科学] R622.12[医药卫生—外科学]