跟骨骨折术后并发症的分析与治疗策略

目的总结分析跟骨骨折术后并发症,以提高手术疗效、改进手术方法。方法分析2005年3月～2010年9月行跟骨骨折切开复位内固定术的66例患者,根据改良Rowe跟骨骨折评价标准评估术后疗效,并对其中出现术后并发症的情况进行分析。结果对患者进行随访,有5例失访,最终纳入研究61例。根据改良Rowe跟骨骨折评价标准,61例中优40例,良12例,可6例,差3例,优良率为85.24%。术后出现切口不愈合或伤口边缘坏死3例;腓骨长短肌腱损伤2例;腓肠神经损伤2例;术后疼痛6例,伤口感染2例。结论术前熟悉跟骨解剖结构及切口周围软组织情况,掌握好手术指征和手术时机,术中规范操作,术后充分引流、积极抗炎是避免发生跟骨骨折手术并发症的关键。

Analysis and treatment strategy of complications after operative fixation for displaced intraarticular calcaneal fractures

Objective To analyze and summarize the complications after operative fixation for displaced intraarticular calcaneal fractures to improve decision-making and efficacy of the treatment.Methods 66 cases with fracture of the calcaneus were treated with the calcaneal plate from May 2005 to September 2010.they were evaluated excellent,good and poor with the modified Rowe for fracture of the calcaneus,and the postoperative complications were analyzed.Results 65 cases were followed up,5cases were lost,totally 61 patients were involved in the result analysis.The clinical results were evaluated according to the modified Rowe for fracture of the calcaneus,and excellent results were achieved in 40 cases,good for 12,average for 6,and poor for 3.The excellent and good rate was 85.24%.3 cases of Incision superficial necrosis or un-healing of the incision in,2 cases of fibular muscle tendinous rupture,2 cases of sural nerves injury,6 cases of pain and 2 cases of depth infection were found.Conclusions In preoperative calcaneal anatomical structure,the surrounding soft tissues,the operation indications and operation time must be mastered.In intraoperative,the operation should be standardized.In postoperative,sufficient drainage and fully active anti-inflammatory must be used.They are the key to avoid the occurrence of the complications of operation for calcaneus fracture.