| 经皮微创钢板内固定与切开复位内固定治疗成人胫骨远端骨折的Meta分析 |
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Received:October 20, 2014
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| 作者 | Author | 单位 | Unit | E-Mail |
| 张庆熙 |
ZHANG Qing-xi |
中日友好医院骨科, 北京 100029 |
Department of Orthopaedics, China-Japan Friendship Hospital, Beijing 100029, China |
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| 高福强 |
GAO Fu-qiang |
中日友好医院骨科, 北京 100029 |
Department of Orthopaedics, China-Japan Friendship Hospital, Beijing 100029, China |
gaofuqiang0604@163.com |
| 孙伟 |
SUN Wei |
中日友好医院骨科, 北京 100029 |
Department of Orthopaedics, China-Japan Friendship Hospital, Beijing 100029, China |
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| 王云亭 |
WANG Yun-ting |
中日友好医院骨科, 北京 100029 |
Department of Orthopaedics, China-Japan Friendship Hospital, Beijing 100029, China |
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| 杨雨润 |
YANG Yu-run |
中日友好医院骨科, 北京 100029 |
Department of Orthopaedics, China-Japan Friendship Hospital, Beijing 100029, China |
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| 李子荣 |
LI Zi-rong |
中日友好医院骨科, 北京 100029 |
Department of Orthopaedics, China-Japan Friendship Hospital, Beijing 100029, China |
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| 期刊信息：《中国骨伤》2015年28卷，第8期，第757-762页 |
| DOI：10.3969/j.issn.1003-0034.2015.08.019 |
| 基金项目:国家自然科学基金(编号:81372013) |
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目的:对经皮微创钢板内固定术(MIPPO)与切开复位内固定术(ORIF)治疗成人胫骨远端骨折的疗效进行Meta分析。
方法:通过计算机检索Pubmed(1968年至2014年3月),Cochrane图书馆、中国知网数据库(1998年至2014年3月),手工检索相关的中英文骨科杂志。收集MIPPO与ORIF治疗成人胫骨远端骨折的病例对照研究,选择术后感染率、手术时间、术中出血量、骨折不愈合率、骨折延迟愈合、骨折畸形愈合率作为Meta分析的评价指标,按Cochrane协作网推荐的方法进行系统评价。
结果:共纳入5项研究366例患者。Meta分析结果显示:MIPPO组感染率低于ORIF组[OR=0.23,95%CI(0.06,0.92),P=0.04];MIPPO组骨折不愈合率低于ORIF组[OR=0.16,95%CI(0.03,0.76),P=0.02];ORIF组骨折畸形愈合率低于MIPPO组[OR=7.46,95%CI(1.68,33.10),P=0.008];MIPPO组手术时间短于ORIF组[MD=-14.42,95%CI(-27.79,-1.05),P <0.05];MIPPO组术中出血量少于ORIF组[MD=-87.17,95%CI(-99.20,-75.15),P <0.05];两组骨折延迟愈合率比较差异无统计学意义。
结论:对于成人胫骨远端骨折,与切开复位内固定治疗相比,经皮微创钢板内固定治疗手术时间短、出血量较少、术后感染率和骨折不愈合率低,但骨折畸形愈合率高。总体来看MIPPO较ORIF治疗成人胫骨远端骨折更有优势,但最佳治疗方案的选择应结合患者的病情进行综合考虑。 |
| [关键词]:胫骨骨折 骨折固定术,内 Meta分析 |
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| Minimally invasive percutaneous plate osteosynthesis versus open reduction and internal fixation for distal tibial fractures in adults:a meta-analysis |
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Abstract:
Objective:To perform a meta-analysis on clinical outcomes of minimally invasive percutaneous plate osteosynthesis (MIPPO) or open reduction and internal fixation (ORIF) for distal tibial fractures in adults.
Methods:Pubmed database (from 1968 to March 2014),Cochrane library and CNKI database (from 1998 to March 2014) were searched. Case-control study on minimally invasive percutaneous plate osteosynthesis (MIPPO) or open reduction and internal fixation (ORIF) for distal tibial fractures in adults were chosen,and postoperative infection,operative time,blood loss,fracture nonunion rate,delayed union,fracture malunion rate were seen as evaluation index for meta analysis. The system review was performed using the method recommended by the Cochrane Collaboration.
Results:Totally 5 studies(366 patients) were enrolled. Meta-analysis showed that there were significant meaning in postoperative infection between MIPPO and ORIF[OR=0.23,95%CI(0.06,0.92),P=0.04];fracture nonunion rate in MIPPO was lower than in ORIF group[OR=0.16,95%CI(0.03,0.76),P=0.02];operative time in MIPPO was shorter than in ORIF group,and had significant difference[MD=-14.42,95%CI(-27.79,-1.05),P <0.05];blood loss in MIPPO was less than in ORIF group[MD=-87.17,95%CI(-99.20,-75.15),P <0.05];there was no obviously meaning in delayed union between two groups .
Conclusion:For distal tibial fractures in adults,MIPPO has advantages of short operative time,less blood loss,lower incidence of infection and fracture non-uniom,but with high fracture malunion rate. MIPPO for distal tibial fractures in adults is better than ORIF,and the best treatment should choose according to patient's condition. |
| KEYWORDS:Tibial fractures Fracture fixation,internal 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: | 张庆熙,高福强,孙伟,王云亭,杨雨润,李子荣.经皮微创钢板内固定与切开复位内固定治疗成人胫骨远端骨折的Meta分析[J].中国骨伤,2015,28(8):757~762 |
| 英文格式: | ZHANG Qing-xi,GAO Fu-qiang,SUN Wei,WANG Yun-ting,YANG Yu-run,LI Zi-rong.Minimally invasive percutaneous plate osteosynthesis versus open reduction and internal fixation for distal tibial fractures in adults:a meta-analysis[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(8):757~762 |
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