| 螺钉及克氏针内固定治疗儿童肱骨外髁骨折疗效的Meta分析 |
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投稿时间：2022-01-08
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| 作者 | Author | 单位 | Address | E-Mail |
| 余向阳 |
YU Xiang-yang |
山西医科大学基础医学院, 山西 太原 030001
山西医科大学骨与软组织损伤修复山西省重点实验室, 山西 太原 030001 |
School of Basic Medicine, Shanxi Medical University, Taiyuan 030001, Shanxi, China
Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Shanxi Medical University, Taiyuan 030001, Shanxi, China |
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| 吴改革 |
WU Gai-ge |
山西医科大学骨与软组织损伤修复山西省重点实验室, 山西 太原 030001 |
Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Shanxi Medical University, Taiyuan 030001, Shanxi, China |
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| 汪航 |
WANG Hang |
山西医科大学基础医学院, 山西 太原 030001
山西医科大学骨与软组织损伤修复山西省重点实验室, 山西 太原 030001 |
School of Basic Medicine, Shanxi Medical University, Taiyuan 030001, Shanxi, China
Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Shanxi Medical University, Taiyuan 030001, Shanxi, China |
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| 黄凌岸 |
HUANG Ling-an |
山西医科大学骨与软组织损伤修复山西省重点实验室, 山西 太原 030001
海南医学院三亚中心医院疼痛医学科, 海南 三亚 572000 |
Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Shanxi Medical University, Taiyuan 030001, Shanxi, China
Department of Pain Medicine, Sanya Central Hospital of Hainan Medical College, Sanya 572000, Hainan, China |
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| 李鹏翠 |
LI Peng-cui |
山西医科大学骨与软组织损伤修复山西省重点实验室, 山西 太原 030001 |
Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Shanxi Medical University, Taiyuan 030001, Shanxi, China |
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| 卫小春 |
WEI Xiao-chun |
山西医科大学骨与软组织损伤修复山西省重点实验室, 山西 太原 030001 |
Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Shanxi Medical University, Taiyuan 030001, Shanxi, China |
sdeygksys@163.com |
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| 期刊信息：《中国骨伤》2024年，第37卷，第4期，第399-405页 |
| DOI：10.12200/j.issn.1003-0034.20221030 |
| 基金项目:国家自然科学基金区域联合重点资助项目(编号:U21A20353) |
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中文摘要:
目的: 通过Meta分析系统评价螺钉及克氏针内固定治疗儿童肱骨外髁骨折的临床疗效。
方法: 计算机检索PubMed、Embase、Cochrane、Web of Science、中国知网、万方数据库建库至2022年2月国内外发表的有关螺钉和克氏针内固定治疗儿童肱骨外髁骨折的文献。根据设定的纳入与排除标准筛选文献并进行质量评价,结局指标为愈合优良率、畸形愈合率、延迟愈合率或骨不连率、感染率、活动受限(>10°)发生率,使用RevMan 5.3软件进行统计分析。
结果: 共纳入9项回顾性研究涉及647例患者,其中螺钉固定组(含螺钉联合克氏针)255例,克氏针固定组392例。Meta分析显示,与克氏针组相比,螺钉组(含螺钉联合克氏针)在术后有更低的感染率[OR=0.22,95 %CI(0.09,0.56),P=0.001]。两组间愈合优良率、畸形愈合率比较,差异均无统计学意义(P>0.05)。亚组分析显示,单纯螺钉组术后感染率显著低于克氏针组[OR=0.18,95 %CI(0.05,0.65),P=0.009]。
结论: 对于手术治疗儿童肱骨外髁骨折,与克氏针内固定和螺钉联合克氏针内固定相比,单纯螺钉内固定拥有更低的感染率。而在愈合优良率、畸形愈合率方面三者无显著差异。就术后疗效及内固定安全性方面而言,更推荐骨科医师使用螺钉进行儿童肱骨外髁骨折的固定。 |
| 【关键词】肱骨外髁骨折 螺钉 克氏针 内固定 儿童 Meta分析 |
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| Screw versus Kirschner wire fixation for lateral humeral condyle fractures in children: a meta analysis |
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ABSTRACT
Objective To compare screw versus Kirschner wire fixation in the treatment of lateral humeral condyle fractures in children.
Methods A systematic search was conducted in PubMed,Embase,the Cochrane library,Web of Science,China National Knowledge Internet(CNKI),Wanfang Datebase from in ception to February 2022. Studies comparing screws and Kirschner wire fixation in the treatment of lateral humeral condyle fractures in children were included. Outcome measures included and excluded by a set of inclusion and exclusion criteria and evaluated for their quality,their excellent and good rate of fracture healing,malunion,delayed union or nonunion,infection,limitation of elbow flexion or extension(>10°) were extracted and analyzed using software Rev Man 5.3.
Results A total of 9 retrospective studies involving 647 patients were included,with 255 patients in the screw fixation group(including screw combined with Kirschner wire) and 392 patients in the Kirschner wire fixation group. Meta analysis showed the following:infection rate in the screw group was significantly lower than that in the Kirschner wire group[OR=0.22,95 %CI(0.09,0.56),P=0.001]. There were no significant differences between the 2 groups in excellent and good rate of fracture healing,malunion rate(P>0.05). Subgroup analysis showed that infection rate in the screw-only group was significantly lower than that in the Kirschner wire group[OR=0.18,95 %CI(0.05,0.65),P=0.009].
Conclusion For lateral humeral condyle fractures,Screw fixation alone had a lower infection rate than kirschner wire fixation and screw combined with Kirschner wire fixation. There were no significant differences in the excellent and good rate of fracture healing,malunion. In terms of postoperative efficacy and safety of internal fixation,orthopaedic surgeons are more likely to recommend screws for fixation of lateral humeral condyle fractures in children. |
| KEY WORDS Lateral humeral condyle fractures Screw Kirschner wire Fixation Children Meta-analysis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 余向阳,吴改革,汪航,黄凌岸,李鹏翠,卫小春.螺钉及克氏针内固定治疗儿童肱骨外髁骨折疗效的Meta分析[J].中国骨伤,2024,37(4):399~405 |
| 英文格式: | YU Xiang-yang,WU Gai-ge,WANG Hang,HUANG Ling-an,LI Peng-cui,WEI Xiao-chun.Screw versus Kirschner wire fixation for lateral humeral condyle fractures in children: a meta analysis[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(4):399~405 |
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