跟骨骨折内固定术后切口皮肤坏死的预防与对策  

PREVENTION AND COUNTERMEASURE FOR POSTOPERATIVE SKIN NECROSIS AFTER INTERNAL FIXATION FOR CALCANEAL FRACTURES

作　　者：张庆[1] 张广程[1] 狄东华[1] 赵建忠[1] 王波[1] 

机构地区：[1]江苏大学附属医院骨科,江苏镇江212001

出　　处：《承德医学院学报》2015年第4期290-293,共4页Journal of Chengde Medical University

摘　　要：目的:探讨如何有效预防跟骨骨折内固定术后切口皮肤坏死的方法。方法:采用切开复位内固定治疗24例(28足)跟骨关节内骨折患者,手术均采用外侧入路"L"型切口;植骨19足,采取自体髂骨或人工骨植入;术后均留置引流管并冷敷,石膏托或弹力绷带包扎制动。结果:术后根据Maryland足功能评分,优10足、良13足、可5足,优良率为82.14%。术后表浅皮缘坏死6足,占21.42%(6/28),经负压换药后均在6周内痊愈,余病例术后切口愈合良好。结论:手术前后的冷敷、固定,选择合适的手术时间,术中操作规范、微创,跟骨外侧壁良好复位,尽量自体骨植骨,术后通畅引流,是避免跟骨骨折手术后切口皮肤坏死的有效方法。Objective： To investigate effective methods to prevent postoperative skin necrosis after internal fixation for calcaneal fracture. Methods： 24 calcaneal fracture patients（28 feet） were treated with open reduction and internal fixation： The surgical procedure was performed by lateral approach and L type incision. Among them, 19 patients were implanted autogeneic iliac bone or artificial bone. After operation, all the incisions placed drainage tube and ice compress; the ankle joint were fixed by plaster support or elastic bandage. Results： According to Maryland foot function score after operation, the excellent and good rate was 82.14%（23/28）. 6 feet（21.42%） suffered skin necrosis after operation and were cured in 6 weeks after negative pressure dressing change. Conclusions： Cold compress before and after operation, fixation, proper surgical time, standard operation, minimally invasive surgery, good reduction of lateral calcaneal wall, auto-grafting and adequate drainage are effective methods that preventing skin necrosis after calcaneal fracture operation.

关 键 词：跟骨 内固定 坏死 切口 

分 类 号：R683.4[医药卫生—骨科学]