Analysis of the correlation between the extreme temperature of incision surface and non-union of incision in internal fixation of calcaneal fracture

Abstract

Objective To explore the correlation between the extreme temperature of incision surface and non-union of incision in internal fixation of calcaneal fracture. Methods From January 2016 to December 2017, 142 patients with closed unilateral calcaneal fracture treated with open reduction and internal fixation in the Integrated Chinese and Western Medicine Hospital of Wenzhou were enrolled.The incision temperature was collected by infrared radiation thermometers intermittently for 4-5 times, and the extreme values were used for further analysis.The primary endpoint of the study was the incision healing 14 days after surgeries.The patients′ age, gender, inflammatory indicators and body mass index (BMI) were evaluated, as well as related factors such as diabetes and arteriosclerosis. Results All patients completed the follow-up observation 14 days after operation, and finally achieved the wound healing in 105 cases, and the wound non-healing in 37 cases.The average extreme value of low temperature was (34.91±0.47)℃ in the union group and (34.13±0.60)℃ in the disunion group, and the average extreme value of high temperature was (36.61±0.55)℃ in the union group and (36.90±0.52)℃ in the disunion group, there were statistically significant differences between the two groups(t=7.152, -2.762, P=0.000, 0.007). Logistic regression analysis results showed that age[β(regression coefficient)=-0.111], extreme high(β=2.728) or very low (β=-3.854), arteriosclerosis(β=4.597), history of diabetes(β=2.234) were risk factors for incision nonunion(P=0.046, 0.003, 0.001, 0.002, 0.024). Conclusion Extreme incision temperature is observed to be associated with an increased risk of operative incision disunion after open reduction and internal fixation for calcaneal fractures. Key words: Fractures, bone; Calcaneus; Fracture fixation, internal; Body temperature; Wound healing; Postoperative complications; Logistic models