Analysis Of Risk Factors Related To Incision Complications In Modified "L" Approach For Calcaneal Fractures

ObjectiveBy analyzing the related factors that may lead to poor incision healing after the modified "L" approach for calcaneal fractures,and to explore the related risk factors for incision complications after the modified "L" approach,in order to reduce the clinical treatment of calcaneal fractures.The incidence of posterior incision complications provides a reference basis.Materials and methodsUsing the retrospective analysis method of case-control study,a statistical analysis was performed on 68 patients with calcaneal fractures from January 1,2015 to December 31,2020 in the Department of Orthopedics Department of the Affiliated Hospital of a University School of Medicine.The surgical patients underwent the same perioperative treatment,the same surgical procedure,and the same intraoperative treatment operation;they were divided into the well-healed group and the complication group according to the "Information Sheet for Patients with Calcaneal Fractures".The related factors that may affect postoperative incision healing were listed in the list,and the related risk factors were obtained through statistical analysis.P<0.05 was considered statistically significant.ResultsA total of 68 cases of standard calcaneal fracture surgery cases,of which 25 cases of poor incision healing occurred after surgery,accounting for 37%;43 cases of good healing,accounting for 63%.Statistical univariate analysis showed that poor incision healing was related to the patient’s previous smoking history,diabetes history,type of calcaneal fracture,suture method,operation timing,and tourniquet duration;it was related to the patient’s age,gender,drinking history,blood loss,bone grafting Whether or not has nothing to do with BMI index.Multivariate Logistic regression analysis showed that smoking history,diabetes history,suture method,operation timing and tourniquet usage time were independent risk factors.The incidence of postoperative incision complications in smoking patients was 12.547 times that of non-smokers;the incidence of poor incision healing in patients with a history of diabetes was 7.153 times that in patients without diabetes;the incidence of complications in patients with vertical mattress sutures The rate is 7.704 times that of using Allgower-Donati suture;the delayed operation time,the lower the incidence of poor incision healing;the longer tourniquet time,the higher the incidence of poor incision healing.ConclusionIndependent risk factors for poor incision healing after the modified "L" approach for calcaneal fractures included diabetes,smoking,suture method,timing of surgery,and duration of tourniquet use.Therefore,for patients treated with ORIF through the "L" approach of calcaneal fracture,it is necessary to control blood sugar reasonably and strictly control tobacco;the selection of operation time should avoid premature,it is recommended to reduce swelling after injury;the use of tourniquet should be shortened as much as possible during operation.It is recommended to use the Allgower-Donati method to suture the incision,which can reduce the incidence of incision complications to a certain extent,and is conducive to the postoperative recovery of patients.