闭合性舌形跟骨骨折急诊手术治疗

Emergency surgical treatment of closed tongue-type calcaneus fractures

目的 探讨闭合性“舌”形跟骨骨折的急诊手术治疗效果。方法 对2018年3月-2019年5月收治的12例闭合性“舌”形跟骨骨折患者,术前均行X线片检查,急诊行有限切开复位经皮螺钉内固定术。结果 术后患者切口均一期愈合,无感染出现,皮肤损伤面积未出现扩大及进一步坏死。对12例采用门诊复查和电话随访的方式进行5~12个月随访,平均8.32个月,末次随访时按美国矫形足踝协会足功能AOFAS标准评定为(91.64±3.13)分,所有患者均未行二期植皮或皮瓣修复,未出现截肢情况,对术后恢复情况感到满意。结论 当闭合性“舌”形跟骨骨折移位骨块对后方皮肤软组织造成损伤时,有时需要急诊进行手术治疗,通过有限切开复位经皮螺钉内固定技术可有效缓解损伤皮肤张力,术后临床疗效显著。

Objective To explore the effect of emergency operation on closed tongue-type calcaneus fractures. Methods From Mar. 2018 to May. 2019, 12 cases of closed tongue-type calcaneus fractures were collected. There were 10 male patients and 2 female patients. The average age was 48.34 years. All patients were examined by X-ray before operation, and limited open reduction and percutaneous screw fixation were performed in emergency. Results After operation, the incision healed in one stage, no infection occurred, and the area of skin injury did not expand or had further necrosis. 12 patients were followed up for5 months to 1 year by outpatient reexamination and telephone follow-up. The average follow-up time was8.32 months. At the last follow-up, the AOFAS score of foot function of American Orthopedic foot ankle association was(91.64 ± 3.13). The patients did not need second stage skin grafting or flap repair, and there was no amputation. All patients were satisfied with the postoperative recovery. Conclusion When the displaced bone block of closed tongue-type calcaneus fractures causes damage to the skin and soft tissue at the back, it sometimes needs emergency surgery. Limited open reduction and percutaneous screw fixation can effectively relieve the tension of injured skin, and the clinical effect is significant.