【摘要】 目的 探讨跟骨骨折切开复位内固定术后切口缘皮瓣坏死的可能原因及治疗方法。方法 分析42例跟骨骨折切开复位内固定术治疗后发生术后切口缘皮瓣坏死的8例患者的与切口缘皮瓣坏死相关的可能原因及其治疗情况。结果 8例切口皮缘坏死，坏死率为19.05%，坏死部位均为以L形拐角的近端为顶点的两端，局部解剖及伤情因素仍是造成皮瓣坏死的主要因素。结论 注重围手术期的处理及规范手术操作，可以降低皮缘坏死率。

    【关键词】 跟骨;骨折;骨折固定术;内外科皮瓣;坏死

    Possible Causes of flap margin necrosis resulted from internal fixation for calcaneal fractures and management LUO Wei, CHENG Ming-hua, XIAO Xun-gang. Department of Orthopaedics, the first people's Hospital of chengzhou, chengzhou,Hunan, 423000,China

    【Abstract】 Objective To explore possible causes of flap margin necrosis resulted from internal fixation for calcaneal fractures and management of the flap margin necrosis. Methods Forty two patients with calcaneal fractures had been treated by open reduction and internal fixation between Aug.2005 and Nov.2010. Eight cases out of the forty two patients had suffered from flap margin necrosis. The possible causes and management of flap margin necrosis had been analyzed. Results Out of the 42 patients, 8 cases had suffered from marginal necrosis of skin incision, accounting for 19.05%. The proximal top site of L-shaped turning was the location of necrosis. Regional anatomy and the status and the degree of injury were the main causes of flap necrosis. Conclusion Standardizing perioperative management and undergoing delicate surgical procedures may reduce the occurrence of skin flap necrosis. ......