跟骨骨折内固定术后切口愈合不良的临床分析

Preventive measures to faulty union of incisions after internal fixation of calcaneal fractures

[目的]探讨跟骨骨折切开复位内固定术后切口愈合不良的预防措施.[方法]回顾分析2003年11月～2006年7月采用切开复位钢板内固定术治疗的51例（4例是双侧）跟骨骨折,本组有48例得到随访,随访时间6～26个月,平均随访时间14个月.[结果]采用美国足与踝关节协会（AOFAS）的评分标准（满分100分）,评定术后功能为53～98分,平均84.8分,结果优良;术后切口愈合不良9例,切口愈合不良率18.7%,包括皮缘部分坏死5例、切口窦道形成2例、皮缘部分坏死伴浅表感染1例,钢板部分外露1例.[结论]切开复位内固定术治疗跟骨骨折,必须高度重视软组织的处理,从术前、术中、术后给予合理的处理,才能提高切口愈合率.

[ Objective ] To discuss and evaluate preventive measures for faulty union of incisions after internal fixation of calcaneal fractures. [ Method ] Fifty-one cases of calcaneal fractures , of which 4 cases were bilateral fractures, after internal fixation between Nov. 2003 and Jul. 2006 were discussed. Forty-eight cases of 51 cases were followed up, and the following-up time was between 6 months and 26 months, the mean following-up time was 14 months. [ Result] The postoperative function was evaluated with standard of AOFAS, the result was between 53 points to 98 points, the mean point was 84.8, the result was good. The rate of faulty union was 18.7%. Among 9 cases, partial necrosis of incision edge occured in 5 cases, sinus of incision edge occurred in 2 cases, partial necrosis of incision edge accompanying superficial infection occurred in 1 case, partial plate was exposed in 1 cases. [ Conclusion ] In order to get a good healing of incision, taking care of soft tissue of incision in pre-, intra-and post-operation of open reduction of calcaneal fracture should be highly emphasized.