Clinical Fractures After Plate Fixation Of Skin Defect Improved After Lateral Perforator Flap

ObjectiveThrough clinical observation and research, the comparison with the conventional lateral perforator flap sural nerve sural nerve flap after internal fixation of calcaneal fractures disadvantages steel skin defect, as the calcaneal fracture fixation plate skin defects the treatment options provide clinical evidence, and make surgical techniques discussed.Materials and MethodsIn clinical work, the First Affiliated Hospital of Zhengzhou University, analyzed the bone in patients with three subjects during January2006to August2013in the surgical treatment of22cases of hospitalized calcaneal fracture fixation plate skin defects, of which21patients were followed. The patients were divided into traditional sural nerve flap group (control group) and the improved lateral perforator flap group (treatment group),10cases from the control group,11cases from treatment group, patients from both groups were observed in1. operation time2. Amount of bleeding3. flap survival4. Rate of treatment success5. Degree of injury of the area and the appearance of it6. flaps and sural nerve area of foot sensation and other indicators for evaluation. Patients were followed up from6months to24months, an average of18months. Statistical Methods:The data were compared before and after the group and between the two groups, classified information withx2test, the mean data using t test for statistical analysis using statistical software SPSS13.0when P<0.05when you think there are statistics significance.Results1. Operation time surgery was completed by the same surgeon physicians.The traditional operative time was85-131minutes, with an average of100+5.0, compared operative time was78±125points, the difference between the two groups was insignificant and obvious not statistically significant (P>0.05);2. Intraoperative blood loss the amount of blood loss was calculated according to the amount recorded by the surgeon. In the treatment group blood loss was50-70ml, an average at62.3ml, blood loss of the control group was55-75ml, an average at65.2ml, no significant difference between the two groups,which was not statistically significant (P>0.05);3. The incidence of postoperative vascular crisis In the control group of ten cases there was one case had the symptoms of remote flap swelling and blisters formed, after symptomatic treatment, the flap survived, no flap necrosis occured; In the treatment group of eleven cases there were one cases appeared symptoms of about1cm dark swollen blisters at the distal flap,after symptomatic treatment, no flap necrosis occured,4. Treatment success rates:follow-up one year after the operation. In the control group of10cases, there was one relapsed and caught infection in April, incise again, remove the plate debridement, wound closure after antibiotic infusion therapy, cured one week later. In the treatment group,11cases of skin flap survived with good texture, no recurrence of ulcers and infection, but no statistical significance between the two groups.5. The range of the improved lateral perforator flap after incision reduced5.2±1.1-1.2cm than conventional sural nerve flap, greatly reduced the damage to the donor site;6. The improved after the lateral pedicle perforator flap significantly became shorter, sufficient blood supply, did not carry the sural nerve, did not affect the survival rate of the flap, and with and without sural nerve sensory recovery of the flap has no significant difference, but the degree of sensory recovery on the distal lateral foot, the treatment group is obviously much better than the control group;Conclusion1. Compared with traditional sural nerve flap, the improved lateral perforator flap plate fixation of calcaneal fractures within the skin defect has many advantages, such as, abundant blood supply for the flap, high survival rate, smaller injury for the operative area, better appearance and function,better lateral distal foot sensory recovery.2. From the standpoint of appearance and function evaluation, the improved lateral perforator flap is a better way to repair after internal fixation of calcaneal fractures steel skin defects, steel bone exposed is a better way and worthy of clinical application;...