摘要
背景:跟骨具有其特殊的解剖结构,且内侧很难暴露到跟距关节面后侧;跟骨外侧软组织少,切开后可清晰暴露跟距关节面,所以跟骨手术切口常规选择跟骨外侧L形切口。目的:分析影响跟骨骨折切开复位钛板及植骨内固定外侧L形切口愈合的可疑因素。方法:自2011年6月至2014年11月纳入辽宁省残疾人康复中心收治的跟骨骨折患者84例94侧,按照移植骨的来源分组,其中同种异体骨移植组52侧(44例),自体髂骨移植组42侧(40例)。跟骨手术时间为伤后7-10 d,经跟骨外侧L形切口行切开复位钛板及植骨内固定,将患者年龄、植骨种类、引流方式、引流时间等作为可能引起切口并发症的因素进行调查分析。结果与结论:184例94侧跟骨骨折内固定修复后发生并发症16侧;2负压引流与皮片引流在切口并发症的发生率方面差异有显著性意义(P<0.05),负压引流对减少切口并发症的发生具有明显的作用;3同种异体骨移植组与自体髂骨移植组在切口并发症的发生率方面差异有显著性意义(P<0.05),植自体髂骨能显著减少切口并发症的发生;4有并发症组与无并发症组患者在年龄、引流时间上差异无显著性意义(P>0.05);5提示伤后7-10 d肿胀完全消退后手术,伤口行负压引流、植自体髂骨可以降低跟骨骨折切开复位植骨钛板内固定外侧L形切口相关并发症的发生率。
BACKGROUND：Calcaneus has its special anatomy.Moreover,it is difficult to expose the inside to the posterior side of the joint surface.Lateral calcaneal soft tissue was less.The joint surface can be clearly exposed after incision,so lateral L-shaped incision is conventionally used in calcaneal surgery.OBJECTIVE：To analyze the suspicious factors influencing the open reduction titanium plate for calcaneal fracture and internal fixation of L-shaped wound healing during bone graft.METHODS：A total of 84 cases（94 sides） of calcaneal fractures,who were treated in the Disabled Rehabilitation Center in Liaoning Province from June 2011 to November 2014,were included in this study.They were grouped according to the source of bone graft.Allograft group contained 52 sides（44 cases）.Autogenous iliac bone graft group contained 42 sides（40 cases）.Operation time of calcaneus was 7-10 days after injury.L-shaped incision was made for open reduction and internal fixation with titanium plate and bone graft.The patient＇s age,the type of bone graft,type of drainage and drainage time that may cause the incision complications were investigated and analyzed.RESULTS AND CONCLUSION：（1） Among 84 cases of 94 calcaneal fractures after operation,16 sides affected complications.（2） Significant differences in the incidence of complications were detected between negative pressure drainage and skin flap drainage（P〈 0.05）.Negative pressure drainage had a significant effect on reducing the incidence of incision complications.（3） Significant differences in the incidence of incision complications were determined between the allograft group and autogenous iliac bone graft group（P〈 0.05）.Implantation of autogenous iliac bone could significantly reduce the incidence of incision complications.（4） No significant difference was detected between the complication group and non-complication group in age and drainage time（P〈 0.05）.（5） These findings indicate that 7-10 days after injury,operation after the swelling subsided completely,the negative pressure drainage,and planting autogenous iliac crest can reduce the incidence of complications related to lateral calcaneal L-shaped incision.
出处
《中国组织工程研究》
CAS
北大核心
2016年第26期3876-3882,共7页
Chinese Journal of Tissue Engineering Research
