章氏超减张缝合Pilon骨折高张力切口  

Zhang's tension-reduced suture for high tension incision for Pilon fracture

作　　者：王磊 张申申 黄其龙 苏郁 郭卫中 WANG Lei;ZHANG Shen-shen;HUANG Qi-long;SU Yu;GUO Wei-zhong(Department of Traumatic Orthopaedic,Mindong Hospital,Fujian Medical University,Fu'an 355000,China)

机构地区：[1]福建医科大学附属闽东医院创伤骨科,福建福安355000

出　　处：《中国矫形外科杂志》2024年第13期1229-1232,共4页Orthopedic Journal of China

摘　　要：[目的]介绍章氏超减张缝合技术在Pilon骨折高张力切口中的应用和初步临床效果。[方法]2019—2022年收治的Pilon骨折中11例高张力切口应用章氏超减张缝合。该缝合方法进针点分列切口两侧,与切口轴向间距约1 cm;起始点及终止点分别位于切口延长线两端,距离切口约1 cm。于切口一端起始点自皮下垂直进针,顺序穿经皮下组织、真皮层、表皮层并出针,再由同一点自皮肤表面垂直进针,顺序穿经表皮层、真皮层、皮下组织,适度拉紧皮肤组织后于皮肤表面穿皮点处形成凹陷,连续缝合至切口另一端,于终点皮下打结。[结果]所有患者均一期闭合切口,11例中10例切口甲级愈合,1例切口愈合不良,二期扩创后愈合,无感染、皮瓣坏死。随访时间平均(13.5±3.2)个月。末次随访时AOFAS踝-后足评分平均(85.3±4.4)分,其中优6例,良3例,可2例。[结论]章氏超减张缝合法可以一期关闭高张力Pilon骨折切口,能有效降低切口并发症。[Objective]To introduce the surgical technique and preliminary clinical outcomes of Zhang's tension-reduced sutures for high-tension incision secondary to open reduction and internal fixation(ORIF)of Pilon fracture.[Methods]A total of 11 patients had incisions closed by this tension-reduced suture following ORIF of Pilon fractures from 2019 to 2022.The enter points of the suture were separated on both sides of the incision,with distance from the incision edge about 1cm.The starting point and the ending point were located at both ends,about 1cm away from the incision.At one end of the incision,the needle was vertically inserted into the subcutaneous tissue,dermis and epidermis in order to exit the needle;at the same point,the needle was vertically inserted into the skin surface in order to penetrate the epidermis,dermis and subcutaneous tissue,and the skin surface to form a depression at the puncture point after moderately tightening the skin tissue,and was continuously stitched to the other end of the incision,and the subcutaneous knot was tied at the end.[Results]This Zhang's tension-reduce suture can close the high-tension after ORIF of Pilon fracture in one-stage,and can effectively reduce the complication of the incision.

关 键 词：PILON骨折 伤口闭合技术 减张缝合 

分 类 号：R683.42[医药卫生—骨科学]