| 皮瓣间断牵开在跟骨骨折L形手术切口中的应用 |
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投稿时间：2022-03-23
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| 作者 | Author | 单位 | Address | E-Mail |
| 明安世 |
MING An-shi |
江汉大学附属黄陂区人民医院骨科, 湖北 武汉 430300 |
Department of Orthopaedics, Jianghan University Affiliated Huangpi People's Hospital, Wuhan 430300, Hubei, China |
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| 成国祥 |
CHENG Guo-xiang |
江汉大学附属黄陂区人民医院骨科, 湖北 武汉 430300 |
Department of Orthopaedics, Jianghan University Affiliated Huangpi People's Hospital, Wuhan 430300, Hubei, China |
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| 朱登峰 |
ZHU Deng-feng |
江汉大学附属黄陂区人民医院骨科, 湖北 武汉 430300 |
Department of Orthopaedics, Jianghan University Affiliated Huangpi People's Hospital, Wuhan 430300, Hubei, China |
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| 刘永国 |
LIU Yong-guo |
江汉大学附属黄陂区人民医院骨科, 湖北 武汉 430300 |
Department of Orthopaedics, Jianghan University Affiliated Huangpi People's Hospital, Wuhan 430300, Hubei, China |
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| 汪洁 |
WANG Jie |
江汉大学附属黄陂区人民医院骨科, 湖北 武汉 430300 |
Department of Orthopaedics, Jianghan University Affiliated Huangpi People's Hospital, Wuhan 430300, Hubei, China |
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| 李红军 |
LI Hong-ju |
江汉大学附属黄陂区人民医院骨科, 湖北 武汉 430300 |
Department of Orthopaedics, Jianghan University Affiliated Huangpi People's Hospital, Wuhan 430300, Hubei, China |
lihongjun7172@163.com |
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| 期刊信息：《中国骨伤》2023年，第36卷，第4期，第320-325页 |
| DOI：10.12200/j.issn.1003-0034.2023.04.005 |
| 基金项目: |
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中文摘要:
目的： 探讨皮瓣间断牵开技术在跟骨骨折"L "形手术切口中的临床疗效。
方法： 自2017年1月至2019年1月采用" L"形手术切口切开复位钢板内固定治疗SandersⅡ-Ⅳ型跟骨骨折患者48例,根据术中皮瓣牵拉方法不同分为观察组和对照组,各24例。观察组男17例,女7例,年龄20~60(45.12±9.56)岁;Sanders Ⅱ型7例,Ⅲ型10例,Ⅳ型7例;Tscherne-Gotzen软组织评估C0级3例,C1级16例,C2级5例;采用间断牵拉技术治疗。对照组男19例,女5例,年龄20~60(47.32±10.67)岁;SandersⅡ型7例,Ⅲ型11例,Ⅳ型6例;Tscherne-Gotzen软组织评估C0级2例,C1级18例,C2级4例;采用静态牵拉技术治疗。观察并比较两组患者手术时间、皮瓣牵拉时间,比较术前和术后3 d两组Böhler角、Gissane角变化情况及切口并发症发生情况。
结果： 术后48例患者获得随访,时间3~6(4.52±1.01)个月。两组手术时间、手术前后Böhler角和Gissane角变化情况比较,差异无统计学意义(P>0.005)。观察组术中皮瓣牵拉时间与对照组比较,差异有统计学意义(P<0.05)。观察组切口并发症发生明显低于对照组(P<0.05)。
结论： 皮瓣间断牵开技术在降低跟骨骨折术中"L"形切口并发症方面优于静态牵开技术,单针牵开不影响术中骨折显露、复位及固定。 |
| 【关键词】跟骨骨折 切口 并发症 |
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| Application of intermittent flap opening in L-shaped surgical incision of calcaneal fracture |
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ABSTRACT
Objective To explore clinical effect of intermittent flap opening technique in L-shaped incision of calcaneal fracture.
Methods From January 2017 to January 2019,48 patients with Sanders typeⅡ to Ⅳ calcaneal fractures were treated by open reduction and internal fixation. According to different flap opening techniques,the patients were divided into control group and observation group,24 patients in each group. In observation group,there were 17 males and 7 females,aged from 20 to 60 years old with an average of(45.12±9.56) years old;7 patients were typeⅡ,10 patients were type Ⅲ and 7 patients were type Ⅳ according to Sanders classification;3 patients were C0,16 patients were C1 and 5 patients were C2 according to Tscherne-Gotzen soft-tissue assessment;treated with intermittent flap technique. In control group,there were 19 males and 5 females aged from 20 to 60 years old with an average of (47.32±10.67) years old;7 patients were typeⅡ,11 patients were type Ⅲ and 6 patients were type Ⅳ according to Sanders classification;2 patients were C0,18 patients were C1 and 4 patients were C2 according to Tschemc-Gotzen soft-tissue assessment;treated with static flap opening technique. Operation time,flap retraction time,changes of Böhler angle and Gissane angle before and after operation at 3 days,and occurrence of incision complications were observed and compared between two groups.
Results All patients were followed up from 3 to 6 months with an average of(4.52±1.01) months. There were no significant differences in operation time,changes of Böhler angle and Gissane angle before and after operation at 3 days between the two groups(P>0.005);there was statistical difference in flap retraction time between two groups(P<0.05). Occurrence of incision complications in observation group was significantly lower than that in control group (P<0.05).
Conclusion Intermittent flap opening technique is superior to static opening technique in reducing incision complications of lateral "L" approach of calcaneus. Single Kirschner wire opening does not affect the exposure,reduction and fixation of fracture during operation. |
| KEY WORDS Calcaneal fracture Incision Complication |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 明安世,成国祥,朱登峰,刘永国,汪洁,李红军.皮瓣间断牵开在跟骨骨折L形手术切口中的应用[J].中国骨伤,2023,36(4):320~325 |
| 英文格式: | MING An-shi,CHENG Guo-xiang,ZHU Deng-feng,LIU Yong-guo,WANG Jie,LI Hong-ju.Application of intermittent flap opening in L-shaped surgical incision of calcaneal fracture[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(4):320~325 |
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