钢板内固定治疗跟骨骨折的并发症

目的总结跟骨骨折的手术并发症，为提高手术疗效、改进手术方法提供借鉴。方法对1997年10月～2003年6月因跟骨骨折进行切开复位钢板内固定治疗的66例患者进行随访，并对出现的并发症进行分析。结果66例68足中。54足骨折愈合优良，14足术后发生或合并有跟骨复位不佳、畸形愈合、切口裂开、感染、螺钉松动等并发症。结论切开复位钢板内固定可作为治疗跟骨骨折的一种方法，但其操作方法、内固定系统还需进一步完善与改进；手术中复位充分可以减少并发症。

The complications following treatment of calcaneal fracture with internal fixation with steel plate

Objective The complications of internal fication for calcaneal fracture were summarized and discussed to increase awareness of these complications, and to improve decision making and efficacy of the treatment. Methods The patients admitted to our hospital from October 1997 to June 2003 were followed up. The fracture in 68 feet (66 patients) was treated with open reduction and internal fixation (ORIF) using steel plate. The complications associated with ORIF were analyzed and discussed as to etiology, incidence, diagnosis, prevention and treatment. Results The patients were followed up for 7 to 57 months. Complications were found in 14 cases, including postoperative wound dehiscence in 5 (infection in 2), malunion (failure to achieve reduction) and arthritis in 9, accompanied by nerve injury in 6. The percentage of complication was 20 6%. With timely treatment, good function was regained in most of the patients. Conclusion Should attention be paid to the operation, many complications could be avoided. ORIF with plate is one ot the options for the treatment of this fracture, but the operative technic and the device should be improved. As the anatomy of the calcaneus is different from a long bone, it is unsuitable to apply the principle and device that are used in the internal fixation of a long bone to this fracture. The plate and screws used in the fixation of the calcaneal fracture can not give enough support