锁定钢板皮外放置治疗跟骨骨折并发症及应对策略探析.docVIP

锁定钢板皮外放置治疗跟骨骨折并发症及应对策略探析 　　摘 要 目的：探索锁定钢板皮外放置治疗跟骨骨折的并发症及应对策略。方法：按纳入标准选择病例75例，撬拨复位后将锁定钢板皮外放置固定，随访18～36个月，评价足部功能，观察并发症。结果：足部功能优66例，良6例，中3例，差0例，优良率96%。未观察到骨折不愈合、固定物松动断裂、皮瓣坏死等并发症发生。钉道反应9例（12%）、腓骨长短肌腱受累5例（6.67%）、腓肠神经受累6例（8%）。 结论：锁定钢板皮外放置固定治疗跟骨骨折，能够有效规避骨折不愈合、固定物松动断裂、皮瓣坏死等传统术式的并发症，其他并发症通过简单治疗可以获得良好控制 关键词 锁定钢板 跟骨骨折 并发症 中图分类号：R683.42 文献标识码：B 文章编号：1006-1533（2017）01-0047-03 Complications and preventive solution of locking plate placed outside the skin in the treatment of calcaneus fracture XU Juliang1*， CHEN Qi2 （1. Qixian Community Health Service Center of Fengxian District， Shanghai 201403， China； 2. The Hospital affiliated to Jiangsu University， Zhenjiang 212000， China） ABSTRACT Objective： To explore the complications and preventive solution of the application of locking plate placed outside the skin in the treatment of calcaneus fracture. Methods： Seventy-five cases were selected based on the inclusive criteria. A locking plate was percutaneously fixed after poking reduction and the patients were followed up for 18～36 months. The function of foot was assessed and the complications of surgery were observed. Results： There were 66 cases excellent， 6 cases good， 3 cases moderate and 0 case bad in the assessment of foot functions， in which the excellent and good rates accounted for 96%. The complications such as nonunion of fracture， breakage and loosening of fixation， flap necrosis were not observed， however， 9 cases （12%） of reaction around nails， 5 cases （6.67%） of injury of tendon of peroneus longus and brevis and 6 cases （8%） of injury of sural nerve were observed. Conclusion： The complications of traditional surgical procedures mentioned above can be avoided by the way of locking plate placed outside the skin and fixation while the other complications can be easily controlled by simple symptomatic treatment. KEY WORDS locking plate； calcaneus fracture； complication 跟骨是人?w承重性最强的跗骨，其损伤较为常见。传统方法采用切开复位内固定术式，术中软组织剥离过多，易损伤软组织血运，引起皮瓣坏死，不符合BO原则[1]。为此，足踝外科医生