| 空心钉与接骨板内固定治疗肱骨大结节骨折疗效的Meta分析 |
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Received:May 09, 2020
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| 作者 | Author | 单位 | Unit | E-Mail |
| 武翔 |
WU Xiang |
山西医科大学第二医院骨科, 山西 太原 030000 |
Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan, 030000 Shanxi, China |
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| 李飞 |
LI Fei |
山西医科大学, 山西 太原 030000 |
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| 尹静 |
YING Jing |
山西医科大学, 山西 太原 030000 |
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| 陈斌 |
CHEN Bin |
山西医科大学第二医院骨科, 山西 太原 030000 |
Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan, 030000 Shanxi, China |
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| 苏煜轩 |
SU Yu-xuan |
山西医科大学, 山西 太原 030000 |
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| 孙海钰 |
SUN Hai-yu |
山西医科大学第二医院骨科, 山西 太原 030000 |
Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan, 030000 Shanxi, China |
shy1995@126.com |
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| 期刊信息：《中国骨伤》2021年34卷，第2期，第180-190页 |
| DOI：10.12200/j.issn.1003-0034.2021.02.017 |
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目的：比较空心钉与接骨板治疗肱骨大结节骨折的临床疗效。
方法：计算机检索PubMed、EMbase、Cochrane图书馆、万方、中国知网、中国生物医学文献数据库、维普中文网等数据库采用空心钉与接骨板治疗肱骨大结节骨折的临床试验文献。检索时间自2010年1月1日至2020年1月1日。根据纳入与排除标准进行独立文献筛选、质量评价及数据提取。采用Revman 5.2软件对所得数据进行Meta分析。
结果：共检索了5篇临床随机对照试验文献及12篇回顾性队列研究文献，共1 068例患者，其中空心钉内固定治疗559例，接骨板内固定治疗509例。Meta分析显示，两组方式手术时间［MD=-23.03，95%CI（-29.69，-16.36），P<0.000 1］，术中出血量［MD=-36.39，95%CI（-53.73，-19.04），P<0.000 1］，住院时间［MD=-1.86，95%CI（-3.09，-0.64），P=0.003］，骨折愈合［MD=-2.23，95%CI（-4.27，-0.18），P=0.03］，术后感染发生率［OR=0.17，95%CI（0.03，0.97），P=0.05］，内固定失效率［OR=3.56，95%CI（1.29，9.81）P=0.01］比较差异有统计学意义。两种方式术后疼痛模拟评分（visual analogue scale，VAS）［MD=-1.34，95%CI（-2.77，0.09），P=0.07］，美国肩肘外科协会评分（American Shoulder and Elbow Surgeons，ASES）［MD=0.26，95%CI（-6.43，6.96），P=0.94］，Constant肩关节评分［MD=-4.05，95%CI（-8.51，0.42），P=0.08］，Constant肩关节评分优良率［MD=-1.30，95%CI（0.46，3.72），P=0.62］，Neer肩关节评分优良率［OR=2.04，95%CI（0.97，4.28），P=0.06］，总并发症发生率［OR=1.50，95%CI（0.42，5.35），P=0.53］，术后疼痛发生率［OR=0.74，95%CI（0.04，14.49），P=0.84］及术后肩峰综合征发生率［OR=0.88，95%CI（0.02，40.63），P=0.95］比较差异无统计学意义。
结论：采用空心钉较接骨板治疗肱骨大结节骨折手术时间短，术中出血量少，住院时间短，术后感染发生率更低且更有利于骨折愈合。 |
| [关键词]:肱骨骨折 骨折固定术，内 Meta分析 |
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| Clinical effects between cannulated screw and bone plate internal fixation for humeral tuberosity fracture: a Meta analysis |
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Abstract:
Objective: To compare clinical effect of cannulated screw and bone plate for the treatment of humeral fracture of greater tuberosity.
Methods: From January 2010 to January 2020,clinical trial literatures on the treatment of humeral tuberosity fractures with cannulated screw and bone plate were searched by PubMed,EMbase,Cochrane Library,Wanfang,CNKI,CBM Database,VIP Database and other databases. Independent literature screening,quality evaluation,and data extraction were performed according to inclusion and exclusion criteria. Revman5.2 software was used to perform Meta analysis
Results: Totally 5 clinical randomized controlled trials and 12 cohort studies were selected,including 1 068 patients in which 559 patients were treated by cannulated screw internal fixation and 509 patients treated by bone plate internal fixation. Meta analysis resluts showed that there were satistical differences in operation time[MD=-23.03,95% CI(-29.69,-16.36),P<0.000 1],blood loss[MD=-36.39,95% CI(-53.73,-19.04),P<0.000 1],hospital stay[MD=-1.86,95%CI(-3.09,-0.64),P=0.003],fracture healing time[MD=-2.23,95% CI(-4.27,-0.18),P=0.03],postoperative incidence of infection[OR=0.17,95%CI(0.03,0.97),P=0.05],failure rate of internal fixation[OR=3.56,95% CI(1.29,9.81),P=0.01] bwteen two groups. While there were no differences in postoperative visual analogue scale(VAS)[MD=-1.34,95% CI(-2.77,0.09),P=0.07],American Shoulder and Elbow Surgeons(ASES)[MD=0.26,95% CI(-6.43,6.96),P=0.94],Constant shoulder score[MD=-4.05,95% CI(-8.51,0.42),P=0.08],excellent rate of Constant shoulder score[MD=-1.30,95% CI(0.46,3.72),P=0.62],excellent rate of Neer shoulder joint score[OR=2.04,95% CI(0.97,4.28),P=0.06],total complication rate[OR=1.50,95% CI(0.42,5.35),P=0.53],incidence of postoperative pain[OR=0.74,95% CI(0.04,14.49),P=0.84] and incidence of postoperative acromion syndrome[OR=0.88,95% CI(0.02,40.63),P=0.95] between two groups.
Conclusion: Compared with bone plate,cannulated screw for the treatment of humeral fracture of greater tuberosity has advantages of shorter opertaion time,less blood loss,shorter hospital stay,lower incidence rate of postopertaive infection,and more benefit for fracture healing. |
| KEYWORDS:Humeral 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: | 武翔,李飞,尹静,陈斌,苏煜轩,孙海钰.空心钉与接骨板内固定治疗肱骨大结节骨折疗效的Meta分析[J].中国骨伤,2021,34(2):180~190 |
| 英文格式: | WU Xiang,LI Fei,YING Jing,CHEN Bin,SU Yu-xuan,SUN Hai-yu.Clinical effects between cannulated screw and bone plate internal fixation for humeral tuberosity fracture: a Meta analysis[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(2):180~190 |
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