跟骨骨折内固定术后皮缘坏死原因分析与处理策略的探讨

Causes of flap margin necrosis in internal fixation for calcaneal fractures and management

目的:通过分析影响跟骨骨折切开复位内固定术后皮瓣愈合的围手术期因素,查找引起皮缘坏死的原因,降低皮缘坏死发生率。方法:对32例跟骨骨折切开复位内固定的病例进行随访,分析其临床资料。结果:7例切口皮缘坏死,坏死率为21.9%,坏死部位均为L形拐角的近端顶点处。结论:注重围手术期的处理及规范手术操作,可以降低皮缘坏死率,但是局部解剖及伤情因素仍是造成皮瓣坏死的主要因素。

Objective： To investigate the causes of flap margin necrosis in internal fixation for calcaneal fractures and reduce the incidence. Methods： Documents of 32 patients with calcaneal fractures undergoing open reduction and internal fixation were reviewed. Results： Of the 32 patients, 7cases occurred marginal necrosis of skin incision, accounting for 21.9 %. The proximal top site of L - shaped turning was the location of necrosis. Conclusion： Regional anatomy and degree of injury are the main causes of flap necrosis. Standardizing perioperative management and undergoing delicate surgical procedures may reduce the occurrence of skin flap necrosis.