髓内钉与锁定接骨板治疗肱骨近端两部分骨折的Meta分析

发布时间：2018-04-11 07:38

本文选题：假体和植入物 + 内固定器　；参考：《中国组织工程研究》2017年03期

【摘要】：背景:切开复位钢板内固定及闭合复位髓内钉内固定技术是治疗肱骨近端两部分骨折的常用方法,但对于哪种内固定更好仍然有很大争议。目的:应用Meta方法分析髓内钉与锁定接骨板治疗肱骨近端2部分骨折的疗效。方法:通过计算机检索Pub Med、SCI、Embase、Cochrane图书馆及中国生物医学数据库、维普信息数据库、万方数据库、相关期刊论文,有关髓内钉与锁定接骨板治疗肱骨近端两部分骨折的随机对照和半随机对照试验,应用Rev Man 5.2统计学软件对两种治疗方式的手术时间、术中出血量、骨折愈合时间、术后并发症(异位骨化、内固定疼痛、螺钉切出、肱骨头坏死)、术后肩关节Constant评分等进行Meta分析。结果与结论:共纳入临床对照试验6个,共259例患者,其中接受髓内钉治疗131例,锁定接骨板治疗128例。Meta分析显示:髓内钉与锁定接骨板治疗肱骨近端两部分骨折的骨折愈合时间、异位骨化并发症发生率、术后内固定部位疼痛发生率、肱骨头坏死发生率、术后总体并发症发生率及术后肩关节Constant评分比较差异无显著性意义,但髓内钉治疗肱骨近端两部分骨折的手术时间、术中出血量、术后螺钉切出率明显少于锁定接骨板治疗(P0.05)。结果表明对比锁定接骨板,髓内钉治疗肱骨近端两部分骨折可降低术后螺钉切出率。
[Abstract]:Background: open reduction and plate internal fixation and closed reduction and intramedullary nail fixation are common methods for the treatment of proximal humeral fractures, but there is still a great deal of controversy about which internal fixation is better.Objective: to analyze the effect of intramedullary nail and locking plate in the treatment of proximal humerus fracture by Meta.Methods: the Pub Medsite Embase Cochrane Library, China Biomedical Database, Weip Information Database, Wanfang Database, full text Database of Chinese Journals were searched by computer.A randomized controlled and semi-randomized controlled trial of intramedullary nail and locking plate for the treatment of two parts of proximal humerus fractures was conducted. Rev Man 5.2 statistical software was used to evaluate the operative time, intraoperative bleeding volume and fracture healing time of the two treatments.Postoperative complications (heterotopic ossification, internal fixation pain, screw excision, humeral head necrosis, postoperative shoulder Constant score, etc.) were analyzed by Meta.Results and conclusion: a total of 259 patients were enrolled in 6 clinical controlled trials, of which 131 received intramedullary nail therapy.Meta-analysis of 128 cases of locking plate therapy showed that the fracture healing time, ectopic ossification complication, postoperative internal fixation pain and brachial head necrosis were observed in the treatment of proximal humeral fractures by intramedullary nail and locking plate.There was no significant difference in the incidence of postoperative complications and the postoperative Constant score of shoulder joint, but the operative time, intraoperative blood loss and screw excision rate of intramedullary nail for two parts of proximal humerus fracture were significantly lower than that of locking plate therapy (P0.05).The results showed that intramedullary nail treatment of proximal humerus fracture could reduce the rate of screw excision compared with locking plate.
【作者单位】：延安大学附属医院骨科四病区;延安大学附属医院血液免疫科;
【分类号】：R687.3

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