锁骨骨折手术与非手术治疗的Meta分析  

A Comprison of Operative and Nonoperative Treatment of Clavicle Fracture:a Meta-Analysis

作　　者：谷贵山 张进[1] 王铁军[1] 王刚[1] 

机构地区：[1]吉林大学第一医院骨关节一科,辽宁吉林132000

出　　处：《实用骨科杂志》2009年第3期161-165,共5页Journal of Practical Orthopaedics

摘　　要：目的通过Meta-分析来比较锁骨骨折手术与非手术的疗效。方法通过检索最近10年的关于锁骨骨折手术与非手术治疗对照研究的4篇文章,采用循证医学Meta分析法对肩关节功能、残余疼痛、术后并发症、愈合率及患者满意度进行综合分析。结果Meta分析发现,手术治疗与非手术治疗相比较,在肩关节功能、残余疼痛及患者满意度方面并无明显统计学差异;手术治疗可大大提高骨折愈合的机会,而非手术治疗可明显降低并发症发生机会。结论手术治疗除了能提高骨折愈合率之外与非手术治疗没有明显差异,因此在临床工作中对于治疗方法的选择应该谨慎。Objective To assess the effects of operative and nonoperative treatment of the clavicle fracture by meta-analysis. Methods Date sources were studies identified by using the Pubmed medline database,Ovid medline database and CNKI database,scanning of the relevant reference lists. The key words were ＂clavicle＂ and ＂fracture＂. We used fixed-effect model of recta-analysis with RevMan software. Results We pooled and analysised 4 control studies comparing operative with nonoperative treatment of clavicle fracture,including a total of 270 patients. One study is RCT. We found there was no significant difference in the shoulder dysfunction （OR=0.94,95%0 CI （0.46,1. 91 ）,P = 0.44 homogeneity, P = 0.84）. There was no significant difference in the shoulder pain （OR = 1.05,95% CI （0.54,2.02）, P = 0.16 homogeneity ,P ： 0.86）. There was no significant difference in the satisfaction of patients （OR =1.13,95%CI （0.43,2.92）,P=0.51 homogeneity,P=0.81）. We also found an higher risk of nonunion in operative treatment than in nonoperative treatment （OR=4. 10,95% CI （1.31,9.28）,P=0.06 heterogeneity,P=0.01）. The risk of complication was unknown in our study （OR = 1.04,P= ？ ,P = 0. 004）. Conclusion The operative treatment was no better than nonoperative treatment. But this result must be checked scientific. We hope there will be more and more excellent RCTs,so we can make a better meta-analysis.

关 键 词：锁骨 骨折 META分析 手术 非手术 

分 类 号：R683.41[医药卫生—骨科学]