关键词: “L”形切口, 中青年闭合性跟骨骨折, 术后康复期, 患足肿胀, 相关因素

Abstract: Objective To investigate the related factors of chronic swelling of the foot during the rehabilitation period after the treatment of closed calcaneal fractures in the young and middle-aged with "L" -shaped incision, and to provide references for clinical improvement of the prognosis of calcaneal fractures. Methods All patients with closed calcaneal fractures who met the selection criteria and were treated with traditional "L"-shaped approach surgery in the Department of Lower Extremity Traumatology and Orthopedics of Heyuan City Hospital of Traditional Chinese Medicine from September 2017 to December 2020 were selected, including 42 males and 18 females, 25 cases of 15-44 years old and 35 cases of 45-59 years old. Among them, patients suffered from foot swelling 6 weeks after the operation were regarded as a swelling group, and patients without foot swelling as a non-swelling group. Based on the data of the two groups, the analysis and discussion were carried out. Based on patients' follow-up data, the factors that might affect chronic swelling of the foot after calcaneal fracture surgery were selected, including patients' age, gender, body mass index, smoking, and other general conditions, as well as fracture classification, surgical conditions, and early postoperative wound healing. χ2 test was used and multivariate logistic stepwise regression analysis was performed based on the univariate analysis results to screen out the related factors of chronic swelling of foot after calcaneal fracture surgery. Results A total of 60 patients were enrolled, including 45 patients in the swelling group and 15 patients in the non-swelling group. Logistic regression analysis showed that usage time of tourniquet over 80 min, type Ⅳ fracture, poor fracture reduction quality, and wound complications were related factors of chronic swelling of the foot during the rehabilitation period after the treatment of closed calcaneal fractures with "L" -shaped approach surgery (all OR>1, P<0.05). Conclusions In the clinical treatment of young and middle-aged patients with closed calcaneal fractures through the traditional "L" -type approach, foot swelling is likely to occur during the postoperative rehabilitation period. Further analysis of related factors has found out that the intraoperative tourniquet used for a long time, the degree of injury as serious as type Ⅳ fracture, poor fracture reduction, and wound complications are the main factors. By circumventing these factors during the perioperative period, the incidence of foot swelling during the postoperative rehabilitation period can be greatly reduced.

Key words: "L" -shaped incision, Closed calcaneal fractures in the young and middle-aged, Postoperative rehabilitation period, Swelling of the affected foot, Related factors