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首页> 外文期刊>Patient Safety in Surgery >High incidence of post-operative infection after ‘sinus tarsi’ approach for treatment of intra-articular fractures of the calcaneus: a 5?year experience in an academic level one trauma center
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High incidence of post-operative infection after ‘sinus tarsi’ approach for treatment of intra-articular fractures of the calcaneus: a 5?year experience in an academic level one trauma center

机译：“鼻窦”法治疗跟骨关节内骨折后的术后感染率高：在一个学术级别的创伤中心有5年的工作经验

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Background The optimal management of displaced intra-articular calcaneal fractures remains a topic of debate among trauma surgeons. The purpose of this study was to assess the safety of the sinus tarsi approach in regard to the incidence of deep infection and amputation following open reduction and internal fixation intra-articular calcaneal fractures. Methods We conducted a retrospective chart review of all patients with displaced intra-articular calcaneus fractures treated with internal fixation through the sinus tarsi approach in a five year period. All surgeries were performed in a single level one trauma center by a single orthopedic trauma fellowship trained surgeon. Results Seventeen patients with an average age of 36.6?±?13.6?years (range 12–61 years) met the inclusion criteria. The time between injury and surgery was on average 6.1?days (range 1–22 days). Average follow up was 116?±?78.2?days (range 3–276 days). Two patients (11.7%) had diabetes mellitus. None of the patients required amputation. Three patients (17.6%) developed deep infection and underwent subsequent formal irrigation and debridement, two of these requiring multiple repeat surgeries in addition to hardware removals. Negative pressure wound therapy and long term antibiotics via peripherally inserted central catheter (PICC) were necessary in these three patients with wound infections. Conclusion The sinus tarsi approach for intra fixation intra-articular calcaneal fractures is safe as compared to the traditional extensile approach in regard to flap necrosis and amputation. However, the rate of deep infection was higher than previously described in the literature.
机译：背景技术关节内跟骨骨折移位的最佳处理仍然是外科医生争论的话题。本研究的目的是就切开复位复位内固定治疗跟骨关节内骨折后深部感染和截肢的发生率，评估鼻窦入路的安全性。方法我们对所有在五年内通过窦镜入路内固定治疗的移位的跟骨关节内骨折患者进行回顾性图表回顾。所有手术均由一名骨科创伤研究培训的外科医生在一个一级创伤中心进行。结果17例平均年龄为36.6？±13.6？岁（12-61岁）的患者符合纳入标准。受伤与手术之间的时间平均为6.1天（1-22天）。平均随访时间为116±78.2天（范围3-276天）。两名患者（11.7％）患有糖尿病。没有患者需要截肢。三名患者（17.6％）发生深部感染，随后接受了正规的冲洗和清创术，其中两名除硬件去除外还需要多次重复手术。在这三例伤口感染患者中，负压伤口治疗和通过外围插入式中心导管（PICC）的长期抗生素治疗是必要的。结论与传统的伸张性方法相比，窦内睑内固定术治疗跟骨关节内骨折在皮瓣坏死和截肢方面是安全的。但是，深层感染率高于以前的文献中描述的水平。

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