Analysis Of Factors About Wound Complications Following Operative Reduction And Internal Fixation Of Calcaneal Fracture With An Extensile Lateral L-Shaped Approach

Objective To find out the related factors of wound complications after ORIF of calcaneal fracture with an extensile lateral L-shaped approach,therefor,the anylysis can provide reference for reducing the incidence of wound complications.Materials and Methods A retrospective comparative analysis was made of 78 patients with calcaneal fractures who met the exclusion criteria from January 2012 to October 2018 in the Department of Traumatic Orthopaedics in First and Second Affiliated Hospital of Guangxi Medical University.On the rule for same perioperative management,according to the Information Table of Patients,the patients were divided into non-complications group and complications group.The factors that may affect the healing of wound were collected and analysed with SPSS version 24.0.P < 0.05 had statistical significance.Outcomes There were 19 wound complications in 78 cases: 1 cases of edge necrosis of wound skin,1 case of wound hematoma,13 cases of wound flushing,edema,poor healing of exudation,4 cases of wound superficial infection.Statistical analysis showed that the occurrence of wound complications was correlated with smoking before operation,surgical timing and operation time,but not with age,sex,BMI,left of right,preoperative VAS,WBC,NEU,Hb,FBG,ALB,intraoperative bleeding volume,causes of injury,Sanders classification,preoperative Gissanse and Bohler angle,recovery value of Gissanse and Bohler angle.Multivariate Logistic regression analysis showed that surgical timing ≤7 days was 12.1 times higher in the risk of wound complications,operative time >120 mins was 15.6 times higher,and smoking before surgery was 6.5 times higher.In calcaneal fracture caused by falling injury at high altitude,falling height has an impact on wound complications.Conclusion The study showed that the independent risk factors of wound complications after ELA-ORIF treatment of calcaneal fractures were the time from injury to operation,the length of operation,and smoking before surgery.In calcaneal fracture caused by falling injury at high altitude,wound complications are more likely to occur when falling height is higher than 4 M.Therefore,in the treatment of calcaneal fracture by ELA-ORIF,we should shorten the surgical time as far as possible,fully relax flap of injured side in order to improve the soft tissue condition,warn patients to quit smoking immediately and try to maintain a smoke-free ward.Although the fall height can not be controlled artificially,we should be alert to the patients whose fall height is more than 4 m and pay attention to protecting soft tissue during the operation.Only in this way can we reduce the postoperative wound complications.