title: [Non-operation related risk factors of wound complications of calcaneal fractures using lateral extensive L-shaped incision].
abstract: OBJECTIVE
  To analyze the non-operation related risk factors of the wound complications by using lateral extensive L-shaped incision for open reduction and internal fixation of calcaneal fractures.
  
  
  METHODS
  A retrospective analysis was made on the clinical data of 58 patients with closed calcaneal fractures (63 calcaneus) treated by using lateral intensive L-shaped incision for open reduction and internal fixation between September 2006 and August 2011. There were 52 males (56 calcaneus) and 6 females (7 calcaneus), aged 18 to 64 years (mean, 35 years). The causes of injury included fall injury in 53 cases (58 calcaneus), traffic injury in 5 cases (5 calcaneus). The mean time between injury and operation was 8 days (range, 3-22 days). According to Sanders classification, 4 calcaneus were rated as type II, 31 calcaneus as type III, and 28 calcaneus as type IV. Postoperative complications were observed and graded; 58 patients were divided into complication group (> or = grade 2) and control group (< grade 2). The univariate analysis was used to analyze 18 factors which may lead to wound complications; multi-factor unconditioned logistic regression analysis was done for the factors showing significant difference.
  
  
  RESULTS
  According to postoperative wound complications grading, 41 patients (46 calcaneus) were included in the control group, whose incision healed primarily, and 17 patients (17 calcaneus) in the complication group. In 17 patients of the complication group, 14 had skin necrosis or dehiscence, and 3 had superficial infection; they obtained healing after symptomatic treatment. The univariate analysis showed significant differences in combined spinal fracture, diabetes mellitus, and long-term smoking between 2 groups (P < 0.05). The logistic regression analysis revealed that combined spinal fracture was an independent risk factor for wound complications (95% confidence interval: 0.004-0.360, P = 0.004).
  
  
  CONCLUSIONS
  Combined spinal fracture is an independent risk factor for wound complications after open reduction and internal fixation of calcaneal fracture using lateral extensive L-shaped incision.
authors: Department of Orthopedics, Shanxi Academy of Medical Sciences, Shanxi Grand Hospital, Taiyuan Shanxi, 030009, PR China.
authors: Dongsheng
authors: D
authors: Hao
authors: Chen
authors: C
authors: Chen
authors: Dong
authors: D
authors: Wang
authors: Yunsheng
authors: Y
authors: Yin
mesh_terms: D000293:Adolescent; D000328:Adult; D002111:Calcaneus / Q000293:injuries* / Q000601:surgery; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D050723:Fractures, Bone / Q000601:surgery*; D005596:Fractures, Closed / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D016103:Spinal Fractures / Q000453:epidemiology*; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult