外固定架联合双层VSD治疗对开放性跟骨骨折愈合的影响  

Effect of external fixator combined with double-layer VSD on the healing of open calcaneal fractures

作　　者：郭晓征 黄津汉 GUO Xiaozheng;HUANG Jinhan(Department of Orthopedics,Eco-City Hospital,Tianjin Fifth Central Hospital,Tianjin 300467,China)

机构地区：[1]天津市第五中心医院生态城医院骨科,天津300467

出　　处：《中国处方药》2024年第11期189-192,共4页Journal of China Prescription Drug

摘　　要：目的 探究外固定架联合双层负压封闭引流(VSD)治疗开放性跟骨骨折的临床疗效。方法 选取医院2018年8月~2023年8月收治的70例开放性跟骨骨折患者,随机分为对照组(n=35)和研究组(n=35)。对照组采用复位手术外固定架联合普通换药引流治疗,研究组采用复位手术外固定架联合双层VSD治疗。比较两组常规临床指标、影像学指标、切口并发症,采用Maryland足功能评分系统评估患者足功能恢复情况。结果 两组切口干燥时间差异无统计学意义(P> 0.05),研究组伤口愈合、骨折愈合时间短于对照组,切口感染、皮瓣转移术发生情况少于对照组(P <0.05);术后1个月,研究组Maryland足功能评分显著高于对照组,足功能优良情况显著优于对照组(P <0.05);术后1个月研究组Bohler角、Gissane角、跟骨高度大于对照组且内侧缩短率小于对照组(P <0.05);研究组切口并发症发生率低于对照组(P <0.05)。结论 外固定架联合双层VSD治疗可更好改善开放性跟骨骨折患者临床症状、足功能,加速患者术后恢复,且具有较少的并发症。Objective To investigate the clinical efficacy of external fixator combined with double-layer VSD in the treatment of open calcaneal fracture.Methods A total of 70 patients with open calcaneal fracture included in a hospital from August 2018 to August 2023 were selected and randomly divided into the control group(n=35)and the study group(n=35).The control group was treated with reduction and external fixator combined with ordinary dressing change and drainage,and the study group was treated with reduction and external fixator combined with double-layer VSD.The routine clinical indicators,imaging indexes and incision complications of the two groups were compared,and the recovery of foot function was evaluated by the Maryland foot function scoring system.Results There was no significant difference in incision drying time between the two groups(P>0.05),the wound healing time and fracture healing time in the study group were shorter than those in the control group,and the incidences of incision infection and flap transfer were lower than those in the control group(P<0.05).At one month after operation,the Maryland score in the study group was significantly higher than those in the control group,and the excellent foot function was significantly better than that in the control group(P<0.05),and the Bohler angle,Gissane angle and calcaneal height in the study group were greater than those in the control group and the medial shortening rate was lower than that in the control group(P<0.05).The total incidence rate of incision complications in the study group was significantly lower than that in the control group(P<0.05).Conclusion The external fixator combined with double-layer VSD has a good effect in the treatment of patients with open calcaneal fracture,which can better improve the clinical symptoms and foot function of patients,accelerate the postoperative recovery of patients,and have fewer complications.

关 键 词：外固定架 双层负压封闭引流 开放性跟骨骨折 愈合时间 

分 类 号：R687.3[医药卫生—骨科学]