比较髓内钉与钢板在胫骨远端关节外骨折中应用的meta分析
发布时间：2019-06-01 10:53
【摘要】：目的随着复位及固定技术的发展,对于髓内钉及钢板这两种内固定方式在胫骨远端关节外骨折中的疗效存在一定的争议。本文希望通过meta分析来阐明两者在胫骨远端关节外骨折中临床疗效及并发症发生率的优劣,并且试图找到影响两者疗效差异的影响因素。 方法本文搜索的检索式为“("Fracture Fixation, Intramedullary"[Mesh]) AND ("Tibial Fractures "[Mesh]) AND (plate OR plating)"。通过PubMed, EMBASE, OVID, Scopus, ISI Web of Science, Cochrane Library, Clinical Trial Grade Center,中国维普期刊和中国万方数据库这7个数据库的检索,我们纳入了所有关于比较髓内钉和钢板在胫骨远端关节外骨折中应用疗效的前瞻性及回顾性研究,这些研究结果中包含了临床功能评分及并发症发生率。我们并没有规定文献的发表年限和语种。本文结果主要比较了两种术式术后并发症发生率、功能评分、疼痛评分,同时也分析了愈合时间、手术时间和住院时间。 结果我们总共纳入了14篇文献,合计样本量为842人。相比于钢板,髓内钉明显表现出较高的功能评分(P=0.01)、较低的感染率(p=0.02),但是髓内钉在畸形愈合率方面结果并不如钢板如此理想(p0.0001)。对于疼痛评分(P=0.33)、总体并发症发生率(P=0.53)和愈合时间(p=0.86),两种内固定方式并没有显示出优劣。 结论随着各种髓内钉辅助技术的发展,一旦髓内钉使骨折两端获得良好的对线对位,因其良好的临床功能恢复和低感染率,髓内钉势必在一定程度上能够替代钢板在胫骨远端关节外骨折中的应用。目前,髓内钉术后的高畸形愈合率仍是困扰我们的一大问题。为了获得更加可信及明确的结果,需要进行更多的关于这方面的临床随机对照研究。
[Abstract]:Objective with the development of reduction and fixation technology, there are some disputes about the curative effect of intramedullary nail and steel plate in the treatment of distal tibia fracture. This article hopes to clarify the clinical efficacy and the incidence of complications in the distal tibia fracture by meta analysis, and try to find out the influencing factors that affect the difference of curative effect between the two. Methods the search formula of this paper is "(" Fracture Fixation, Intramedullary "[Mesh]) AND (" Tibial Fractures "[Mesh]) AND (plate OR plating)"). Through the retrieval of the seven databases of PubMed, EMBASE, OVID, Scopus, ISI Web of Science, Cochrane Library, Clinical Trial Grade Center, China Weipu Journal and China Wanfang Database, We included all prospective and retrospective studies comparing the efficacy of intramedullary nails and plates in the treatment of distal extraarticular fractures of the tibia, including clinical functional scores and the incidence of complications. We do not specify the length of publication and language of the literature. The results showed that the incidence of postoperative complications, functional score and pain score were compared between the two methods, and the healing time, operation time and hospitalization time were also analyzed. Results A total of 14 articles were included, with a total sample size of 842. Compared with steel plate, intramedullary nail showed higher functional score (P 鈮，
本文编号：2490215
[Abstract]:Objective with the development of reduction and fixation technology, there are some disputes about the curative effect of intramedullary nail and steel plate in the treatment of distal tibia fracture. This article hopes to clarify the clinical efficacy and the incidence of complications in the distal tibia fracture by meta analysis, and try to find out the influencing factors that affect the difference of curative effect between the two. Methods the search formula of this paper is "(" Fracture Fixation, Intramedullary "[Mesh]) AND (" Tibial Fractures "[Mesh]) AND (plate OR plating)"). Through the retrieval of the seven databases of PubMed, EMBASE, OVID, Scopus, ISI Web of Science, Cochrane Library, Clinical Trial Grade Center, China Weipu Journal and China Wanfang Database, We included all prospective and retrospective studies comparing the efficacy of intramedullary nails and plates in the treatment of distal extraarticular fractures of the tibia, including clinical functional scores and the incidence of complications. We do not specify the length of publication and language of the literature. The results showed that the incidence of postoperative complications, functional score and pain score were compared between the two methods, and the healing time, operation time and hospitalization time were also analyzed. Results A total of 14 articles were included, with a total sample size of 842. Compared with steel plate, intramedullary nail showed higher functional score (P 鈮，
本文编号：2490215
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