跟骨骨折手术中皮瓣不同牵开方式术后切口并发症的比较

目的:回顾比较跟骨骨折手术中对皮瓣采用拉钩牵开及克氏针固定牵开的病人术后切口的并发症发生率,探讨跟骨骨折手术中对皮瓣最优的牵开方式。方法:对81例89足跟骨骨折应用跟骨外侧"L"形延长切口手术治疗。术中皮瓣拉钩牵开组52足,克氏针固定牵开组37足。结果:术后切口皮肤边缘坏死10例,切口延迟愈合2例,感染1例。其中拉钩牵开组5例,克氏针固定牵开组7例,切口并发症发生率分别为:9.62%,18.92%。经统计比较有差异性(P<0.01)。结论:在跟骨骨折的开放手术治疗中,对皮瓣采用拉钩牵开较克氏针固定牵开的病人术后切口的并发症发生率低。在应用跟骨外侧"L"形延长切口时宜采用拉钩动态牵开皮瓣。

Analysis of Postoperative Wound Complication Rate in Different Flap Opening Method of Calcaneus Fracture Operation

Objective:To investigate the best flap opening mode by comparing wound complication rate of calcaneus fracture operation between different flap opening method. Methods: 81patients with 89 foot calcaneal fractures were treated with"L"shape incision operation on the calcaneus lateral.52cases of calcaneus fractures were used drag hook to pull the flap out, 37 cases used Kirschner wire.Results:The skin incision edge necrosis happened in 10 cases after operation, delayed healing of incision happened in 2 cases, postoperative infection happened in 1 case. 5 cases occurred in the group of drag hook,7 cases occurred in the group of Kirschner wire. Incision complication rates of the two groups of were 9.62%and18.92%.The difference between the two groups was statistically significant (P<0.01).Conclusion:In open operation for the treatment of calcaneal fracture, incision complication rate of drag hook group could be lower than the Kirschner wire group.We should adopt drag hook to open the flap in the "L" shape Calcaneal lateral incision.