手术治疗跟骨骨折护理体会.docVIP

手术治疗跟骨骨折护理体会[摘要] 目的:促进跟骨骨折的早期康复,降低并发症的发生率。方法:对患者进行个性化的术前心理护理,控制肿胀发展、止痛,术后预防并发症发生及指导进行功能训练。结果:优13例,良16例,可2例,优良率94%。1例伤口裂开经充分引流换药伤口愈合,1例伤口感染病例6周后去除内固定物伤口愈合。结论:开放复位+钛板固定治疗跟骨骨折充分恢复了Bohler’s角、距下关节面的平整,恢复了相关动力装置的正常张力,解除了位移骨折块对软组织的不良刺激,明显提高了此种损伤的疗效,显著降低病残率。细致、有步骤的术前及术后护理是非常重要和必不可少的。 [关键词] 跟骨骨折;手术;护理 [中图分类号] R473.6[文献标识码]C [文章编号]1673-7210(2010)04(b)-086-02 The nursing experience of operative treatment of calcaneal fractures WANG Pengfei, MENG Jing (Department of Orthopaedics, Songgang People’s Hospital, Shenzhen518105, China) [Abstract] Objective: To improve the early rehabilitation of calcaneal fractures and decrease the incidence of complications. Methods: Characteric psychology nursing according to each patient given preoperation.Controlled the swell and acesodyne.Prevented complications and directed function exercise postoperation. Results: Wound infection occurred in 1case and healed after the fixtor removed. Acording to Kerr’s evaluated standard: excellent 13 cases, good 16 cases, fair 2 cases, the excellent and good results were obtained in 93%. Conclusion: Open reduction and internal fixtion by titanium plate corrected the Bohler’s angel, the smooth of subtalar articular surfance obtain,the normal tension of dynamical apparatus recover, eliminated the stimination to soft tissue of displaced frcture. Sugery effects improved obviously. The rate of complications decreased too. The carefully nursing perioperation was important and necessery. [Key words] Calcaneal fractures;Operation;Nursing 跟骨骨折常为高能量损伤所致,占全身骨折的2%[1],虽然近年来统计显示开放复位内固定治疗跟骨骨折较非手术方法具有更好的疗效,但伴有较高发生率的伤口感染、裂开、距下关节活动障碍、创伤性关节炎、跟垫问题[2-3]等并发症。围术期护理、手术时机的选择、后期康复训练等对于治疗效果相当重要。2005~2008年,31例跟骨骨折患者于我院行手术治疗获得良好效果,现报道如下: 1资料与方法 1.1一般资料 31例中,男20例,女11例。年龄16~45岁,平均24岁。单侧21例,双侧10例。致伤原因:均为高处坠落伤。合并伤:脊椎损伤8例,上肢3例,颅脑损伤4例,胸肺部损伤5例,骨盆损伤2例。受伤距接受手术时间为5~10 d,最迟不得超过伤后3~4周,其中,2例行急诊手术。术前行跟骨正侧位、轴位X线检查。手术取常规外侧L型入路。骨折复位+跟骨锁定钛板固定。 1.2护理 1.2.1术前护理患者入院后,护士应当迅速熟悉病情,了解伤者心理状况,做好个性化心理护理,消除患者的紧张情绪及恐惧感,取得患者配合。术前