Analysis of risk factors for incision complications after an enlarged lateral "L" incision for open reduction and internal fixation of closed calcaneal fracture
10.3760/cma.j.cn501098-20220607-00422
- VernacularTitle:闭合性跟骨骨折经扩大“L”形切口切开复位内固定术后切口并发症危险因素分析
- Author:
Bin CHEN
1
;
Ke ZHENG
;
Tao HUANG
;
Peisheng CHEN
;
Chaohui LIN
;
Dongze LIN
;
Fengfei LIN
Author Information
1. 厦门大学附属福州第二医院骨科，福建医科大学第三临床医学院，福建省创伤骨科急救与康复临床医学研究中心，福州市创伤医学中心，福州 350007
- Keywords:
Calcaneus;
Fractures, closed;
Postoperative complications;
Surgical wound;
Risk factors
- From:
Chinese Journal of Trauma
2022;38(9):814-820
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors for incision complications in open reduction and internal fixation of closed calcaneal fracture via an enlarged lateral L-shaped incision.Methods:A case-control study was used to analyze the clinical data of 128 patients (139 feet) with closed calcaneal fracture treated by open reduction and internal fixation via an enlarged lateral L-shaped incision in Fuzhou Second Hospital affiliated to Xiamen University from January 2019 to January 2022, including 113 males (123 feet) and 15 females (16 feet); aged 24-79 years [(48.2±10.8)years]. The fracture was on the one side in 117 patients and on both sides in 11 patients. According to Sanders classification, type I was noted in 3 feet, type II in 92, type III in 40, and type IV in 4. All patients were treated with an enlarged lateral L-shaped shaped incision for open reduction and internal fixation. The patients were divided into complication group (33 feet) and control group (106 feet), according to the occurrence of postoperative incisional complications. Data were recorded in both groups, including gender, age, side, fracture subtype, combined fractures, diabetes history, smoking history, local blistering, preoperative waiting time, bone graft, drainage, operative time, time of tourniquet use, number of prophylactic antibiotic use, postoperative treatment to improve microcirculation and preoperative and postoperative laboratory indices (white blood cell count, haemoglobin and albumin). The correlation between the above data and postoperative incisional complications was analyzed using the univariate analysis, followed by identification of independent risk factors by the multi-factor Logistic regression analysis.Results:Univariate analysis showed that diabetes history, smoking history, number of prophylactic antibiotic use, postoperative treatment to improve microcirculation, postoperative albumin and postoperative haemoglobin were associated with postoperative incisional complications (all P<0.05). On the contrary, gender, age, side, fracture subtype, combined fractures, local blistering, preoperative waiting time, bone graft, drainage, operative time, time of tourniquet use, preoperative white blood cell count, preoperative albumin, preoperative haemoglobin and postoperative white blood cell count were not associated with postoperative incisional complications (all P>0.05). Multi-factor Logistic regression analysis showed that diabetes history ( OR=3.51, 95% CI 1.29-9.50, P<0.05), smoking history ( OR=3.53, 95% CI 1.34-9.30, P<0.05), prophylactic antibiotic use<2 times ( OR=2.52, 95% CI 1.04-6.10, P<0.05) and lack of postoperative treatment to improve microcirculation ( OR=2.97, 95% CI 1.79-12.45, P<0.05) were significantly associated with postoperative incisional complications ( P<0.05). Conclusion:Diabetes history, smoking history, prophylactic antibiotic use<2 times and lack of postoperative treatment to improve microcirculation are independent risk factors for incisional complications in open reduction and internal fixation of closed calcaneal fracture via a lateral enlarged L-shaped shaped incision.
