Abstract:

Objective To explore the risk factors relevant to incision complications after closed calcaneal fracture surgery via a lateral L-shaped incision and to evaluate the effectiveness of clinical intervention methods. Methods The medical records of 209 patients (239 calcaneal fractures) were retrospectively analyzed. The univariate analysis of seven factors (the timing of surgery, operative duration, bone grafting, skin distraction method, postoperative drainage, smoking, and antibiotic) that might cause complications of calcaneal incision was conducted. The multiple Logistic regression analysis was conducted for factors with statistical significance. Results Among 239 cases of calcaneal fracture, 21 (8.8%) involved surgical incision complications, including 8 (3.3%) of wound dehiscence, 7 (2.9%) of flap margin necrosis, 5 (2.1%) of hematoma, and 1 (0.4%) of osteomyelitis. The results of univariate analysis showed that six factors were relevant to surgical incision complications, i.e. the timing of surgery, operative duration, postoperative drainage, skin distraction method, bone grafting, and smoking. The results of multiple Logistic regression analysis showed that surgeries performed within seven days after fracture, operative time >1.5 h, no drainage after surgery, static skin distraction, and smoking were risk factors of calcaneal incision complications. The duration of antibiotic administration and bone grafting had no significant effect on incision complications. Conclusion It is helpful for avoiding complications after calcaneal surgeries by postponing the surgery at least 7 d after fracture, shortening the surgery time, performing postoperative drainage, retracting skin flaps gently and shortly, and prohibiting smoking.

Key words: calcaneus, fracture, incision, surgical complication