跟骨骨折切口改良术临床效果观察

Clinical effect observation of incision improvment for calcaneal fracture

目的探讨跟骨骨折内固定术后皮瓣坏死的原因及预防。方法对照组11例采用常规手术方式,改良组35例行外侧切口切开复位钢板内固定治疗,切口于"L形"转为水平后,切口位置宁低勿高。结果对照组9例发生皮瓣坏死,改良组33例切口甲级愈合,2例发生皮瓣坏死,差异有统计学意义(P<0.05)。结论采用改良的手术切口设计和加强对皮瓣的保护,是避免皮瓣坏死的关键。

Objective To investigate the factors of skin flap necrosis after internal fixation for calcaneal fracture,and prevent it.Methods 11 cases in the control group were treated with normal operation,which 35 cases in the reformed group were treated with open reduction through outboard incision and internal fixed with steel plate,the level incision＇s position of the ＂L＂ incision should better be low rather than high.Results In the control group,9 patients＇ skin flap were necrotic;while 33 cases in reformed group incision healing well,2 cases occurred flap necrosis,which suggested statistically significant（P0.05）.Conclusion Modified incision and protection for skin flap are the key points to avoid the necrosis of skin flap.