摘要
目的探讨跟骨关节内骨折内固定手术并发症的预防和治疗。方法对21例(24足)Sanders分型Ⅱ～Ⅳ型骨折行跟骨外侧L形延长切口,直视下以距骨关节面为模板复位、同种异体骨植骨、Y形钢板固定。结果发生并发症4足:2足皮肤坏死,其中1足局部皮瓣转移、另1足游离肌皮瓣移植治愈;1足血肿继发感染,换药治愈;1足复位不良、骨不连,关节融合术治愈。结论皮肤皱褶征阳性为最佳手术时机,全层切开皮肤和“不接触”皮肤保护技术,锐性分离皮瓣,能减少并发症发生。局部皮瓣转移术、游离肌皮瓣移植及关节融合术可治愈并发症。
Objective To study the prevention and treatment of surgical complication of intraartieular ealeaneal fracture. Methods 21 cases （24 feet） with calcaneal fractures were treated through lateral ＂L＂ extended incision. With direct visualization, tarlar articular facet as template, all were undergone allograft and Y-shape plate fixation. Results 4 feet got complications, of which 2 were skin necrosis and healed after flap rotation （ 1 case ） and free flap transplantation （1 case） ; 1 was hematoma infection and healed after dress changing; 1 was malreduction and nonunion and healed after arthrodesis. Conclusions The optimal time of surgery, is skin reductus. With full thickness incision, untouched technique, and acute resection, the complications can be reduced. Local flap rotation, free flap transplantation and arthrodesis are contermeasures when complications present.
出处
《临床骨科杂志》
2006年第5期448-449,共2页
Journal of Clinical Orthopaedics
关键词
跟骨骨折
关节内骨折
骨折固定术
内
手术后并发症
calcaneus fractures
intra articular fracture
fracture fixation internal
postoperative complications
