本文選題：假體和植入物 + 內(nèi)固定器　； 參考：《中國(guó)組織工程研究》2017年03期

【摘要】：背景:切開復(fù)位鋼板內(nèi)固定及閉合復(fù)位髓內(nèi)釘內(nèi)固定技術(shù)是治療肱骨近端兩部分骨折的常用方法,但對(duì)于哪種內(nèi)固定更好仍然有很大爭(zhēng)議。目的:應(yīng)用Meta方法分析髓內(nèi)釘與鎖定接骨板治療肱骨近端2部分骨折的療效。方法:通過計(jì)算機(jī)檢索Pub Med、SCI、Embase、Cochrane圖書館及中國(guó)生物醫(yī)學(xué)數(shù)據(jù)庫(kù)、維普信息數(shù)據(jù)庫(kù)、萬(wàn)方數(shù)據(jù)庫(kù)、相關(guān)期刊論文,有關(guān)髓內(nèi)釘與鎖定接骨板治療肱骨近端兩部分骨折的隨機(jī)對(duì)照和半隨機(jī)對(duì)照試驗(yàn),應(yīng)用Rev Man 5.2統(tǒng)計(jì)學(xué)軟件對(duì)兩種治療方式的手術(shù)時(shí)間、術(shù)中出血量、骨折愈合時(shí)間、術(shù)后并發(fā)癥(異位骨化、內(nèi)固定疼痛、螺釘切出、肱骨頭壞死)、術(shù)后肩關(guān)節(jié)Constant評(píng)分等進(jìn)行Meta分析。結(jié)果與結(jié)論:共納入臨床對(duì)照試驗(yàn)6個(gè),共259例患者,其中接受髓內(nèi)釘治療131例,鎖定接骨板治療128例。Meta分析顯示:髓內(nèi)釘與鎖定接骨板治療肱骨近端兩部分骨折的骨折愈合時(shí)間、異位骨化并發(fā)癥發(fā)生率、術(shù)后內(nèi)固定部位疼痛發(fā)生率、肱骨頭壞死發(fā)生率、術(shù)后總體并發(fā)癥發(fā)生率及術(shù)后肩關(guān)節(jié)Constant評(píng)分比較差異無顯著性意義,但髓內(nèi)釘治療肱骨近端兩部分骨折的手術(shù)時(shí)間、術(shù)中出血量、術(shù)后螺釘切出率明顯少于鎖定接骨板治療(P0.05)。結(jié)果表明對(duì)比鎖定接骨板,髓內(nèi)釘治療肱骨近端兩部分骨折可降低術(shù)后螺釘切出率。
[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.
【作者單位】： 延安大學(xué)附屬醫(yī)院骨科四病區(qū);延安大學(xué)附屬醫(yī)院血液免疫科;
【分類號(hào)】：R687.3

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本文編號(hào)：1735041