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>0.05);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).
CONCLUSIONS: 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.
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>0.05);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).
CONCLUSIONS: 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.
摘要：
目的：探讨间歇开瓣技术在L形切口跟骨骨折治疗中的临床效果。
方法：2017年1月至2019年1月，对48例SandersⅡ～Ⅳ型跟骨骨折患者进行切开复位内固定治疗。根据不同的皮瓣打开技术，将患者分为对照组和观察组,每组24例。在观察组中,有17名男性和7名女性，年龄20～60岁,平均(45.12±9.56)岁;二型7例,根据Sanders分类，Ⅲ型10例，Ⅳ型7例；根据Tscherne-Gotzen软组织评估，C03例，C116例，C25例；间歇皮瓣技术治疗。在对照组中，男19例,女5例,年龄20～60岁,平均(47.32±10.67)岁;二型7例,根据Sanders分类，Ⅲ型11例，Ⅳ型6例；根据Tschemc-Gotzen软组织评估，C02例，C118例，C24例；静态皮瓣开放技术治疗。操作时间,襟翼收回时间,术后3天Böhler角和Gissane角的变化,观察比较两组切口并发症发生情况。
结果：所有患者均获随访3～6个月，平均(4.52±1.01)个月。手术时间无明显差异,两组术后3dBöhler角和Gissane角的变化（P>0.05）；两组皮瓣回缩时间比较差异有统计学意义（P<0.05）。观察组切口并发症发生率明显低于对照组(P<0.05)。
结论：间歇性皮瓣开放技术在减少跟骨外侧“L”入路切口并发症方面优于静态开放技术。单个克氏针开口不影响曝光，术中骨折复位固定。
方法：2017年1月至2019年1月，对48例SandersⅡ～Ⅳ型跟骨骨折患者进行切开复位内固定治疗。根据不同的皮瓣打开技术，将患者分为对照组和观察组,每组24例。在观察组中,有17名男性和7名女性，年龄20～60岁,平均(45.12±9.56)岁;二型7例,根据Sanders分类，Ⅲ型10例，Ⅳ型7例；根据Tscherne-Gotzen软组织评估，C03例，C116例，C25例；间歇皮瓣技术治疗。在对照组中，男19例,女5例,年龄20～60岁,平均(47.32±10.67)岁;二型7例,根据Sanders分类，Ⅲ型11例，Ⅳ型6例；根据Tschemc-Gotzen软组织评估，C02例，C118例，C24例；静态皮瓣开放技术治疗。操作时间,襟翼收回时间,术后3天Böhler角和Gissane角的变化,观察比较两组切口并发症发生情况。
结果：所有患者均获随访3～6个月，平均(4.52±1.01)个月。手术时间无明显差异,两组术后3dBöhler角和Gissane角的变化（P>0.05）；两组皮瓣回缩时间比较差异有统计学意义（P<0.05）。观察组切口并发症发生率明显低于对照组(P<0.05)。
结论：间歇性皮瓣开放技术在减少跟骨外侧“L”入路切口并发症方面优于静态开放技术。单个克氏针开口不影响曝光，术中骨折复位固定。
