改良Allgower-Donati缝合法在跟骨骨折切开复位内固定术后应用效果观察

Application effect observation of modified Allgower-Donati suture after operative open reduction and internal fixation for patients with calcaneal fracture

目的观察改良Allgower-Donati缝合法在跟骨骨折切开复位内固定术后应用效果。方法回顾性分析2015年1月-2018年12月六安市中医院骨伤二科收治的92例跟骨骨折患者临床资料,患者均给予切开复位内固定术治疗。按照缝合方法分为垂直缝合组44例,男性40例,女性4例,年龄22~55岁,平均36.5岁;改良缝合组48例,男性46例,女性2例,年龄21~57岁,平均37.2岁。垂直缝合组给予间断垂直褥式缝合法,改良缝合组给予改良Allgower-Donati缝合法。比较两组患者伤口愈合情况、手术相关指标、临床疗效优良率、并发症发生率及蜈蚣状瘢痕发生率。结果改良缝合组伤口愈合情况优于垂直缝合组。手术相关指标显示,垂直缝合组和改良缝合组患者手术时间、切口缝合时间及引流管留置时间组间比较差异无统计学意义(P>0.05)。垂直缝合组和改良缝合组临床疗效优良率比较差异无统计学意义(90.9%vs.91.7%,P>0.05)。与垂直缝合组相比,改良缝合组患者并发症发生率低(6.2%vs.20.4%),蜈蚣状瘢痕发生率低(0.0%vs.13.6%),组间比较差异有统计学意义(P<0.05)。结论改良Allgower-Donati缝合法应用于跟骨骨折切开复位内固定术,患者伤口愈合好,并发症发生率降低,美容效果好。

Objective To observe the application effect of modified Allgower-Donati suture after operative open reduction and internal fixation for patients with calcaneal fracture.Methods From Jan.2015 to Dec.2018,92 patients with calcaneal fracture who were treated at Department of Orthopedics,Traditional Chinese Medicine Hospital of Luan were retrospectively analyzed.All patients were treated with open reduction and internal fixation.They were divided into 44 cases(vertical suture group,40 males and 4 females,mean age 36.5 years)and 48 cases(modified suture group,46 males and 2 females,mean age 37.2 years)according to different suture methods.The vertical suture group was treated with intermittent vertical mattress suture,and the modified Allgower-Donati suture group was treated with modified Allgower-Donati suture.Then,wound healing,operation-related indexes,good and excellent rate of curative efficacy,incidence of complications and centipede scar were compared between the two groups.Results The wound healing in the modified suture group was better than that in the vertical suture group.Operation-related indexes showed that operation time,suture time and drainage tube retention time in the two groups were statistically same(all P >0.05).Good and excellent rate of curative efficacy in the modified suture group and the vertical suture group was statistically same (90.9% vs.91.7%,P >0.05).In comparison with the vertical suture group,the modified suture group had lower incidence of complications(6.2% vs.20.4%) and centipede scar (0.0% vs.13.6%) with both statistical differences(both P <0.05).Conclusion Modified Allgower-Donati suture has many advantages in open reduction and internal fixation of calcaneal fracture,such as good healing of aluminium wound,lower incidence of complications and good cosmetic effect.