| 螺钉与接骨板内固定治疗Lisfranc损伤疗效的Meta分析 |
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Received:February 20, 2022
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| 作者 | Author | 单位 | Unit | E-Mail |
| 刘明杰 |
LIU Ming-jie |
山西医科大学第二附属医院骨科, 山西 太原 030000 |
Department of Orthopaedics, the Second Affiliated Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China |
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| 陈斌 |
CHEN Bin |
山西医科大学第二附属医院骨科, 山西 太原 030000 |
Department of Orthopaedics, the Second Affiliated Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China |
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| 王浩 |
WANG Hao |
山西医科大学第二附属医院骨科, 山西 太原 030000 |
Department of Orthopaedics, the Second Affiliated Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China |
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| 武翔 |
WU Xiang |
山西医科大学第二附属医院骨科, 山西 太原 030000 |
Department of Orthopaedics, the Second Affiliated Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China |
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| 孙海钰 |
SUN Hai-yu |
山西医科大学第二附属医院骨科, 山西 太原 030000 |
Department of Orthopaedics, the Second Affiliated Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China |
shy1995@126.com |
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| 期刊信息：《中国骨伤》2023年36卷，第7期，第676-685页 |
| DOI：10.12200/j.issn.1003-0034.2023.07.016 |
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目的：比较螺钉与接骨板内固定治疗Lisfranc损伤的临床疗效。
方法：计算机检索万方、CNKI、Pubmed、EMBASE、维普、BIOSIS等数据库，检索时间为2000年1月1日至2021年8月1日的临床试验文献，严格评价纳入研究的方法学质量并提取资料，采用Revman 5.4软件对所得数据进行Meta分析。
结果：纳入随机对照试验文献9篇和回顾性队列研究10篇文献，其中试验组416例患者采用螺钉内固定治疗，对照组435例患者采用接骨板内固定治疗。Meta分析显示：接骨板内固定组手术时间长于螺钉内固定组[MD=-14.40，95% CI= （-17.21，-11.60），P<0.000 01]，接骨板内固定组在术后X线解剖复位情况[MD=0.47，95% CI= （0.25，0.86），P=0.01]、术后美国足踝外科协会（American orthopedic foot and ankle society，AOFAS）足功能评分优良率[MD=0.25，95% CI= （0.15，0.42），P<0.000 01]、术后AOFAS足功能评分[MD=-5.51，95% CI= （-10.10，-0.92），P=0.02]较螺钉内固定组更优。两种手术方式在术后骨折愈合时间[MD=1.91，95% CI= （-1.36，5.18），P=0.25]、术后VAS[MD=0.38，95% CI= （-0.09，0.86），P=0.11]、术后并发症[MD=1.32，95% CI= （0.73，2.40），P=0.36]、术后感染率[MD=0.84，95% CI= （0.48，1.46），P=0.53]、术后内固定失效[MD=1.25，95% CI= （0.61，2.53），P=0.54]和术后创伤性关节炎发生率[MD=1.80，95% CI= （0.83，3.91），P=0.14]方面比较，差异无统计学意义。
结论：接骨板内固定治疗Lisfranc损伤具有更好的短期和中期结果以及更低的再手术率。所以，更推荐采用接骨板内固定治疗Lisfranc损伤。 |
| [关键词]:Lisfranc损伤 骨折固定术,内 Meta分析 |
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| Meta-analysis of the effect of hollow nail and bone plate on Lisfranc injury |
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Abstract:
Objective To compare the clinical efficacy of screw and bone plate internal fixation in the treatment of Lisfranc injury.
Methods The databases of Wanfang, CNKI, Pubmed, EMBASE, VIP, BIOSIS and other databases were retrieved by computer, and the clinical trial literature from January 1, 2000 to August 1, 2021 was retrieved, the methodological quality of the included studies was strictly evaluated and the data were extracted, and the obtained data were meta-analyzed by Revman 5.4 software.
Results Nine randomized controlled trial literature and 10 retrospective cohort studies were included, of which 416 patients in the experimental group were treated with screw internal fixation, and 435 patients in the control group were treated with bone plate internal fixation. Meta-analysis showed that the surgical time of the bone plate internal fixation group was longer than that of the screw internal fixation group[MD=-14.40, 95%CI=(-17.21, -11.60), P<0.000 01], the postoperative X-ray anatomical reduction of the bone plate internal fixation group[MD=0.47, 95%CI=(0.25, 0.86), P=0.01], the excellent and good rate of postoperative American orthopedic foot and ankle society(AOFAS) foot function score[MD=0.25, 95%CI=(0.15, 0.42), P<0.000 01], postoperative AOFAS foot function score[MD=-5.51, 95%CI=(-10.10, -0.92), P=0.02] of the bone plate fixation group was better than those of the screw internal fixation group. Two kinds of operation method had no statistical different for postoperative fracture healing time[MD=1.91, 95%CI=(-1.36, 5.18), P=0.25], postoperative visual analgue scale(VAS)[MD=0.38, 95%CI=(0.09, 0.86), P=0.11], postoperative complications[MD=1.32, 95%CI=(0.73, 2.40), P=0.36], the postoperative infection[MD=0.84, 95%CI=(0.48, 1.46), P=0.53], the postoperative fracture internal fixation loosening[MD=1.25, 95% CI=(0.61, 2.53), P=0.54], the postoperative incidence of traumatic arthritis[MD=1.80, 95%CI=(0.83, 3.91), P=0.14].
Conclusion Bone plate fixation has better short-term and medium-term results and lower reoperation rate in the treatment of Lisfranc injury, so it is recommended to use bone plate fixation in the treatment of Lisfranc injury. |
| KEYWORDS:Lisfranc injury 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: | 刘明杰,陈斌,王浩,武翔,孙海钰.螺钉与接骨板内固定治疗Lisfranc损伤疗效的Meta分析[J].中国骨伤,2023,36(7):676~685 |
| 英文格式: | LIU Ming-jie,CHEN Bin,WANG Hao,WU Xiang,SUN Hai-yu.Meta-analysis of the effect of hollow nail and bone plate on Lisfranc injury[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(7):676~685 |
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