Analysis on the causes of unhealed incision after the operation of calcaneal fracture

Objective To analyze the causes of poor wound healing after the open reduction and internal fixation of closed calcaneal fracture.Methods 61 patients(78 calcaneus) with calcaneal fracture were treated by using the L-shaped incision in lateral calcaneus in our department from May 2009 and May 2013,in which there were 53 males(67 calcaneus) and 8 females(11 calcaneus),and the age ranged from 21 years to 57 years,the mean age was 39 years.There were 56 cases(71 calcaneus) caused by the falling and 5 cases(7 calcaneus) caused by the traffic accident.The operation time ranged from 3 hours to 22 days after the injury,and the mean operation time was 9 days.There were 34 calcaneus with type Ⅱ,31 calcaneus with type Ⅲ,and 13 calcaneus with type Ⅳ according to the Sanders classification.The general condition,operation timing and method,internal fixation choice,treatment after surgery of patients were retrospectively analyzed,and the patients were followed up within 0.5 year to 3 years after surgery,the average follow-up time was 20 months.Results There were 7 patients(9 calcaneus) with incision edge necrosis or dehiscence,which accounted for 11.5% and obtained healing after the symptomatic treatment.Conclusion The incidence of poor wound healing after the operation of calcaneal fracture is associated with the general condition,com plications,anatomical features of calcaneus,operation timing choice,internal fixation choice,operative,postoperative treatment and other factors.