一期清创加内固定治疗开放性跟骨骨折的临床体会

目的探讨一期清创加内固定治疗开放性跟骨骨折的临床效果。方法回顾性分析我院2001年2月至2007年12月对25例27足开放性跟骨骨折行一期清创加内固定术治疗的临床资料。男18例,女7例;年龄14～65岁,平均43.6岁。24例为高处坠落伤,1例为机器绞伤,开放伤口为GustiloⅡ型,骨折均为SandersⅢ～Ⅳ型。手术清创内侧开放伤口,同时外侧扩大L型切口切开复位H或Y型钢板内固定跟骨骨折。结果跟骨高度宽度、Bohlers angle、Gissane angle、跟骨外翻角均得到良好恢复,内侧均伤口一期愈合。21例患者获得随访,随访时间1.2～8.7年,平均6.4年,除1例外侧手术伤口术后2周仍渗液,细菌培养无细菌,经换药后愈合。结论内固定一期用于开放性跟骨骨折的治疗,安全、有效。

Clinical study of one-stage debridement and instrument to open calcaneal fracture

Objective To investigate the efficiency and safety of the one-stage debridement and instrument to open calcaneal fracture. Methods The clinical data of 25 cases of the open calcaneal fracture from Feb 2001 to Dec 2007 were analyzed retrospectively. Results All patients were followed up prospectively for 1.2 to 8.7 years postoperatively. The attitude,width,Bohlers angle and Gissane angle all were resumed There were no wound infection except one case wound not heal. Conclusion One-stage debridement and instrument to open calcaneal fracture is effective and safe.