摘要
目的比较不同缝合方法用于SandersⅢ型跟骨骨折患者术中的临床效果。方法选取2018年3月至2021年3月期间商洛市中医医院收治的100例SandersⅢ型跟骨骨折患者作为研究对象,所有患者均实施跟骨外侧“L”形入路切开复位内固定术,其中58例采用Allgrower-Donati缝合者纳入Allgrower-Donati组,42例采用垂直褥式缝合者纳入垂直褥式组。比较两组患者的手术相关指标(手术时间、伤口缝合时间和伤口愈合时间),术后12 h、24 h、48 h和72 h的切口皮肤温差,切口并发症发生情况及术后6个月足部功能[采用美国矫形外科足踝协会(AOFAS)评分系统评价]评分。结果Allgrower-Donati组患者的手术时间、伤口缝合时间和伤口愈合时间分别为(62.27±3.03)min、(5.84±0.53)min和(13.29±1.76)d,明显短于垂直褥式组的(65.49±3.10)min、(7.04±0.39)min和(19.72±1.93)d,差异均有统计学意义(P<0.05);Allgrower-Donati组患者术后24 h、48 h和72 h切口皮肤温差分别为(1.12±0.37)℃、(0.89±0.26)℃和(0.64±0.18)℃,明显低于垂直褥式组的(1.76±0.44)℃、(1.29±0.32)℃和(0.98±0.24)℃,差异均有统计学意义(P<0.05);Allgrower-Donati组患者术后切口并发症总发生率为3.45%,明显低于垂直褥式组的16.67%,差异有统计学意义(P<0.05);两组患者术后6个月的足部功能AOFAS评分比较差异无统计学意义(P>0.05)。结论与垂直褥式缝合比较,SandersⅢ型跟骨骨折跟骨外侧“L”形入路切开复位内固定术中采用Allgrower-Donati缝合可缩短缝合时间,减少皮瓣血运干扰,切口并发症发生率更低。
Objective To compare the clinical effect of different suture methods in patients with Sanders typeⅢcalcaneal fractures.Methods A total of 100 patients with Sanders typeⅢcalcaneal fractures admitted to Shangluo Hospital of Traditional Chinese Medicine between March 2018 and March 2021were enrolled as the research objects.All patients underwent open reduction and internal fixation via lateral L-shaped approach of calcaneus,including 58 cases treated with Allgrower-Donati suture(Allgrower-Donati group)and 42 cases treated with vertical mattress suture(vertical mattress group).The surgical related indicators(operation time,wound suture time,wound healing time),differences of incision skin temperature at 12 h,24 h,48 h,and 72 h after surgery,occurrence of incision complications,and scores of foot function[American Orthopedic Foot and Ankle Society(AOFAS)scoring system]at 6 months after surgery were compared between the two groups.Results The operation time,wound suture time,and wound healing time in Allgrower-Donati group were(62.27±3.03)min,(5.84±0.53)min,and(13.29±1.76)d,respectively,significantly shorter than(65.49±3.10)min,(7.04±0.39)min,(19.72±1.93)d in vertical mattress group(P<0.05).At 24 h,48 h,and 72 h after surgery,differences of incision skin temperature in Allgrower-Donati group were(1.12±0.37)℃,(0.89±0.26)℃,and(0.64±0.18)℃,significantly lower than(1.76±0.44)℃,(1.29±0.32)℃,(0.98±0.24)℃in vertical mattress group(P<0.05).The total incidence of postoperative incision complications in Allgrower-Donati group was significantly lower than that in vertical mattress group(3.45%vs 16.67%,P<0.05).At 6 months after surgery,there was no significant difference in AOFAS score of foot function between the two groups(P>0.05).Conclusion Compared with vertical mattress suture,application of Allgrower-Donati suture in open reduction and internal fixation via lateral L-shaped approach of calcaneus can shorten suture time and reduce the interference of flap blood supply in the treatment of Sanders typeⅢcalcaneal fractures,with lower incidence of incision complications.
作者
涂凡
雷鸿
寇伟
王勋
魏翀
TU Fan;LEI Hong;KOU Wei;WANG Xun;WEI Chong(Department of Orthopedics,Shangluo Hospital of Traditional Chinese Medicine,Shangluo 726000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2022年第18期2373-2376,共4页
Hainan Medical Journal
基金
陕西省自然科学基础研究计划项目(编号:2016JM8149)。
