【摘要】：目的隨著復(fù)位及固定技術(shù)的發(fā)展,對于髓內(nèi)釘及鋼板這兩種內(nèi)固定方式在脛骨遠端關(guān)節(jié)外骨折中的療效存在一定的爭議。本文希望通過meta分析來闡明兩者在脛骨遠端關(guān)節(jié)外骨折中臨床療效及并發(fā)癥發(fā)生率的優(yōu)劣,并且試圖找到影響兩者療效差異的影響因素。 方法本文搜索的檢索式為“("Fracture Fixation, Intramedullary"[Mesh]) AND ("Tibial Fractures "[Mesh]) AND (plate OR plating)"。通過PubMed, EMBASE, OVID, Scopus, ISI Web of Science, Cochrane Library, Clinical Trial Grade Center,中國維普期刊和中國萬方數(shù)據(jù)庫這7個數(shù)據(jù)庫的檢索,我們納入了所有關(guān)于比較髓內(nèi)釘和鋼板在脛骨遠端關(guān)節(jié)外骨折中應(yīng)用療效的前瞻性及回顧性研究,這些研究結(jié)果中包含了臨床功能評分及并發(fā)癥發(fā)生率。我們并沒有規(guī)定文獻的發(fā)表年限和語種。本文結(jié)果主要比較了兩種術(shù)式術(shù)后并發(fā)癥發(fā)生率、功能評分、疼痛評分,同時也分析了愈合時間、手術(shù)時間和住院時間。 結(jié)果我們總共納入了14篇文獻,合計樣本量為842人。相比于鋼板,髓內(nèi)釘明顯表現(xiàn)出較高的功能評分(P=0.01)、較低的感染率(p=0.02),但是髓內(nèi)釘在畸形愈合率方面結(jié)果并不如鋼板如此理想(p0.0001)。對于疼痛評分(P=0.33)、總體并發(fā)癥發(fā)生率(P=0.53)和愈合時間(p=0.86),兩種內(nèi)固定方式并沒有顯示出優(yōu)劣。 結(jié)論隨著各種髓內(nèi)釘輔助技術(shù)的發(fā)展,一旦髓內(nèi)釘使骨折兩端獲得良好的對線對位,因其良好的臨床功能恢復(fù)和低感染率,髓內(nèi)釘勢必在一定程度上能夠替代鋼板在脛骨遠端關(guān)節(jié)外骨折中的應(yīng)用。目前,髓內(nèi)釘術(shù)后的高畸形愈合率仍是困擾我們的一大問題。為了獲得更加可信及明確的結(jié)果,需要進行更多的關(guān)于這方面的臨床隨機對照研究。
[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，

本文編號：2490215