一期清创负压引流二期复位固定治疗开放性跟骨骨折

【摘要】 目的 评价开放性跟骨骨折手术治疗的临床疗效。方法〓2006年6月~2012年6月对15例开放性跟骨骨折行一期清创负压封闭引流(VSD),二期创面植皮或皮瓣转移修复并骨折复位内固定术治疗,观察手术并发症发生率及关节功能恢复情况,疗效评价采用美国足踝外科协会(AOFAS)踝后足评分标准评估。结果〓所有患者均获随访,随访时间6个月~36个月,平均12.8个月,3例患者手术切口表皮部分坏死,1例部分钢板外露,经换药和VSD处理后愈合。末次随访时所有患者骨折均愈合,平均愈合时间为4个月。AOFAS踝后足评分标准评分为64~90分,平均79.3分,其中优3例,良8例,一般4例,优良率:73.3%。结论〓开放性跟骨骨折采用分期手术治疗策略,可降低手术并发症,初期效果良好。

One stage debridement and vacuum sealing drainage (VSD), two stage reduction and fixation on the treatment of open calcaneal fractures

【Abstract】〓Objective〓To evaluate the clinical effect of staged operation treatment for open calcaneal fractures. Methods〓From June 2006 to June 2012, 15 cases with open calcaneal fractures were treated with one stage debridement and vacuum sealing drainage (VSD), then two stage of skin grafting or flap repair and fracture reduction and internal fixation. The complications and joint function were evaluated by Ankle hind foot scale from USA Association of foot and ankle surgery (AOFAS). Results〓All patients were followed up after operation, and the average follow-up time was 12.8 months (6 months -36 months). Partial incision necrosis happened in 3 patients, partial plate exposure occurred in one case, healing after dressing change and VSD treatment. All fractures healed. The average healing time was 4 months. The average AOFAS ankle hindfoot scale was 79.3 points (64-90 points), including excellent in 3 cases, good in 8 cases, fair in 4 cases, with excellent and good rate 73.3%. Conclusion〓Staged operation strategy for open calcaneal fractures can reduce complications. The initial effect is good.