| 跟骨关节内骨折手术治疗并发症原因分析及对策 |
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投稿时间：2007-01-22
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| 作者 | Author | 单位 | Address | E-Mail |
| 张坚平 |
ZHANG Jian-ping |
杭州市余杭区第三人民医院，浙江 杭州 311115 |
The Third People Hospital of Yuhang District,Hangzhou 311115,Zhejiang,China |
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| 张俊杰 |
ZHANG Jun-jie |
杭州市余杭区第三人民医院，浙江 杭州 311115 |
The Third People Hospital of Yuhang District,Hangzhou 311115,Zhejiang,China |
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| 孔丽萍 |
KONG Li-ping |
杭州市余杭区第三人民医院，浙江 杭州 311115 |
The Third People Hospital of Yuhang District,Hangzhou 311115,Zhejiang,China |
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| 田耜奇 |
TIAN Si-qi |
杭州市余杭区第三人民医院，浙江 杭州 311115 |
The Third People Hospital of Yuhang District,Hangzhou 311115,Zhejiang,China |
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| 杨顺华 |
YANG Shun-hua |
杭州市余杭区第三人民医院，浙江 杭州 311115 |
The Third People Hospital of Yuhang District,Hangzhou 311115,Zhejiang,China |
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| 期刊信息：《中国骨伤》2008年，第21卷，第2期，第124-125页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目: |
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中文摘要:
目的：探讨跟骨关节内骨折手术并发症的发生原因、预防和对策。
方法：跟骨关节内骨折71例(76足),男49例，女22例；年龄19～56岁，平均35.6岁。根据Sanders分类：Ⅱ型23例(24足),Ⅲ型36例(38足),Ⅳ型12例(14足).分别采用切开复位、自体骨植骨加跟骨钢板内固定术治疗。
结果：71例(76足)中，发生早期并发症13足，其中浅层切口裂开伴感染2足，深层切口裂开伴感染1足，尖端伤口坏死7足，骨髓炎1足，腓肠神经损伤2足；晚期发生距下关节炎2足。71例均获随访，时间6个月～3.5年，平均19个月。按Kerr术后疗效评分标准：优34足，良32足，可9足，差1足。
结论：在跟骨关节内骨折手术治疗中，只要严格选择手术适应证，把握合适的手术时机，提高手术技巧并加强围手术期护理就能减少并发症，提高手术的疗效；出现并发症后，可根据情况作出相应处理，能取得满意的疗效。 |
| 【关键词】跟骨 骨折 外科手术 手术后并发症 |
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| Causes and countermeasure of complications in operative management of intra-articular fracture of calcaneus |
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ABSTRACT
Objective: To discuss the probable causes of the post-surgery complications with the intra-artcular fracture of calcaneus,the proper steps for prevention and solution.
Methods: Seventy-one patients(76 injured feet)included 49 males and 22 females aged from 19 to 56 years old(mean 35.6 years). According to Sanders' classification,23 cases(24 injuried feet) belonged to typeⅡ，36 (38 injured feet) were typeⅢ，the remain 12 (14 injured feet) met the criteria of typeⅣ。 All the patients received the operation of open reduction,autogenous bone grafting and internal fixation with stainless steel plates.
Results: Thirteen injuried feet developed early complications. Two injuried feet got the superficial layer of the wound disrupted and infected,1 had the deep layer of the wound disrupted and infected. Cutaneous necrosis at the pointed end of the wound occurred in 7 cases. Another 1 developed osteomyelitis. Two cases suffered from sural nerve damage. Two injuried feet developed late complications,both of them suffered from arthritis of talocalcaneal joint. All the patients were followed up at least 6 months(ranged from 6 to 42 months,mean 19 months). According to Kerr's post-surgery evaluation criteria,34 injuried feet were excellent,32 were fine,9 were acceptable,only 1 was bad.
Conclusion: If proper measures are taken,the post-surgery complications of intra-articular fracture of calcaneus will be reduced. This requires us to be strict in selecting operation indication,to make a good plan and preparation,to select a right time for operation,to improve surgical skills and pay more attention to peri-surgery nursing. If complications happen,according measures should be taken in order to get a better outcome. |
| KEY WORDS Calcaneus Fractures Surgical procedures,operative Postoperative complications |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 张坚平,张俊杰,孔丽萍,田耜奇,杨顺华.跟骨关节内骨折手术治疗并发症原因分析及对策[J].中国骨伤,2008,21(2):124~125 |
| 英文格式: | ZHANG Jian-ping,ZHANG Jun-jie,KONG Li-ping,TIAN Si-qi,YANG Shun-hua.Causes and countermeasure of complications in operative management of intra-articular fracture of calcaneus[J].zhongguo gu shang / China J Orthop Trauma ,2008,21(2):124~125 |
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