跟骨骨折切开复位内固定不同手术时机与术后软组织并发症的关系

Relationship between different surgery time and postoperative soft tissue complications in calcaneal fractures

目的探讨跟骨骨折切开复位内固定不同手术时机与术后软组织并发症的关系。方法回顾性分析接受切开复位内固定治疗的70例78足跟骨骨折患者的临床资料,比较合并术后软组织并发症患者与未合并并发症患者一般资料的差异,并根据不同的手术时机将患者分为伤后8 h内组、伤后8 h^7 d组及伤后7~14 d组,比较不同组别患者术后软组织并发症发生率。结果本组患者术后软组织并发症发生率为19.23%(15/78),其中并发症组吸烟及糖尿病的比例明显高于无并发症组,差异均有统计学意义(P<0.05);伤后8 h内手术者、伤后7~14 d手术者并发症发生率均明显低于伤后8 h^7 d者,差异均有统计学意义(P<0.05)。结论术前禁烟、控制血糖,选择伤后8 h内及伤后7~14 d的最佳手术时机可减少跟骨骨折术后软组织并发症问题。

Objective To investigate the relationship between different surgery time and postoperative soft tissue complications in calcaneal fractures treated by open reduction and internal fixation. Methods The clinical data of 70 patients with calcaneal fractures（78 feet） was analyzed retrospectively, and the data was compared between patients complicated with postoperative soft tissue complications（complication group） and those not（without complication group）. Depending on the timing of surgery, the patients were divided into 8 h after injury group, 8 h-7 d group and 7-14 d after injury group. The incidence of postoperative soft tissue complications were compared between different groups. Results In this study, the rate of postoperative soft tissue complications was 9.23%（15/78）, and the rate of smoking and diabetes in complication group was significantly higher than those without complication group, with statistically significant difference（P〈0.05）. The complication rate of surgery in 8 h after injury group and 7-14 d after injury group was significantly lower than that 8 h-7d after injury group, and the difference was statistically significant（P〈0.05）. Conclusion Preoperative no smoking, controlling blood glucose, selecting the optimal timing of surgery in8 h and 7-14 d after injury can reduce postoperative soft tissue complications of calcaneal fractures.