Treatment Of Calcaneal Fracture With L Shape Approach And Analysis Of The Factors Affecting The Incision Complications

Objective Objective to investigate the effect of treatment of closed calcaneal fracture with lateral L approach,and to analyze the related factors of postoperative incision complications.Methods This retrospective study,clinical data were collected in our hospital from January 2008 to January 2015 were parallel lateral "L" approach in the treatment of closed calcaneal fracture,a total of 283 cases,including 103 cases of Sanders type,Sanders type 121 cases,Sanders type in 59 cases,192 were male,91 female;age 26-60 the average age of 36.5 years old.Record the preoperative and postoperative Bohler angle and Gissane angle value,postoperative 1-2 Maryland foot standard for evaluation of postoperative observation;no incision complications,analysis of related variables may affect postoperative wound complications,including sex,smoking history,drinking his tory,diabetes,bone grafting,length of surgery,injury to surgery time,uses SPSS17.0 statistical so ftware for data analysis,count data and packet level data with 2 test,for each factor were analyzed by single factor analysis,univariate analysis showed there were significant and Logistic multivariate regression analysis.The difference was statistically significant,P<0.05 said.Results All 283 patients were followed up for 12~24 months,with an average of 17 months.The preoperative and postoperative Bohler angles and Gissane angle values were statistically different(P<0.05).According to the Maryland foot scale,Sanders II type was excellent in 95 cases,the excellent and good rate was 92%,Sanders type III was excellent in 103 cases,the excellent and good rate was 85%,and the excellent number of Sanders and IV was 40 cases,the excellent and go od rate was 68%.The difference of goodness rate was statistically significant(P<0.05).The total excellent and good rate was 84%.Postoperative complications occurred in 48 cases,and the incidence of incision complications was 17%,including 6 cases of skin margin necrosis,23 cases of superficial infection and 19 cases of poor wound healing.After the antibiotic application,the regular change dressing treatment,the incision merge stitches.There were 14 cases with complication of Sanders type II incision,the incidence rate was 13.6%,Sanders type III incision complications occurred in 18 cases,the incidence rate was 14.9%,Sanders type IV incision complications occurred in16 cases,the incidence was 27.1%.There was no significant difference in the incidence of incisio nal complications(P> 0.05).The total incidence of incision complications was 17%.The suspicio us factors of postoperative wound complications were analyzed by single factor analysis,single factor analysis of statistically significant factors of Logistic regression analysis,found that smoking,di abetes,operation time,time from injury to operation was statistically significant(P<0.05).Conclusion L shaped by lateral approach in the treatment of calcaneal fractures,there were statistically significant differences in the excellent and good rate of various types of surgery,type II Sanders highest Sanders III type,Sanders type is the worst;suspicious explore the impact factors of incision complications,found that smoking,diabetes,operation time,injury the time to surgery is effect of postoperative wound complications related factors.