Yu Xiao, Pang Qing-Jiang, Chen Liang, Yang Chang-Chun, Chen Xian-Jun
Department of Orthopaedics, Ningbo No. 2 Hospital, Ningbo, China.
J Int Med Res. 2014 Feb;42(1):17-25. doi: 10.1177/0300060513495626. Epub 2013 Dec 10.
To review postoperative complications reported after closed calcaneus fracture treated by open reduction and internal fixation (ORIF).
Postoperative complications reported in the literature between 1995 and 2012 were identified. Papers were retrieved from publicly available databases and included in this study if they met the following criteria: clinical research of cases of closed calcaneus fracture treated by ORIF; ≥10 cases; detailed information about complications, treatment and follow up.
Twenty-one clinical reports were analysed (2046 cases). Reported complications (and incidence rates) were: infection and skin flap necrosis (13.6%); neurovascular injury (2.8%); post-traumatic arthritis (1.2%); malreduction/implant problems (0.8%); nonunion (0.1%).
Postoperative complications after closed calcaneus fracture are common clinical problems that cannot always be avoided. They can even be life altering, due to the requirement for long-term treatment or amputation and their economic impact on the patient. Complications should be diagnosed and treated promptly, to achieve satisfactory outcomes. Nonsurgical treatment (e.g. local wound care, drugs or physical therapy) can be attempted. If such measures fail, surgical treatment (e.g. debridement, skin flap transplantation, implant removal, re-opening of the reduction and internal fixation or subtalar joint arthrodesis) should be considered.
回顾切开复位内固定（ORIF）治疗闭合性跟骨骨折后报告的术后并发症。
确定1995年至2012年文献中报告的术后并发症。从公开可用数据库检索论文，若符合以下标准则纳入本研究：ORIF治疗闭合性跟骨骨折病例的临床研究；≥10例；有关并发症、治疗及随访的详细信息。
分析了21篇临床报告（共2046例）。报告的并发症（及发生率）为：感染及皮瓣坏死（13.6%）；神经血管损伤（2.8%）；创伤后关节炎（1.2%）；复位不良/植入物问题（0.8%）；骨不连（0.1%）。
闭合性跟骨骨折术后并发症是常见临床问题，并非总能避免。由于需要长期治疗或截肢及其对患者的经济影响，这些并发症甚至可能改变生活。应及时诊断和治疗并发症以取得满意疗效。可尝试非手术治疗（如局部伤口护理、药物或物理治疗）。若此类措施失败，应考虑手术治疗（如清创、皮瓣移植、取出植入物、重新切开复位内固定或距下关节融合术）。
