Lisfranc损伤切开复位内固定术与关节融合术临床疗效的Meta分析  

Efficacy of Primary Arthrodesis and Open Reduction and Internal Fixation in the Treatment of Lisfranc Joint Injuries:A Meta Analysis

作　　者：杨茂伟[1] 梁单[1] 郭宝磊[1] 曹军军[1] 于江[1] 

机构地区：[1]中国医科大学附属第一医院骨科,沈阳110011

出　　处：《中国医科大学学报》2011年第4期364-367,共4页Journal of China Medical University

摘　　要：目的比较Lisfranc损伤切开复位内固定术与关节融合术的临床疗效。方法收集所有比较Lisfranc损伤关节融合术与切开复位内固定术的随机对照实验(RCT)和临床对照实验(CCT),按Cochrane协作网标准逐个进行质量评价和Meta分析。结果对符合纳入标准的3篇RCT文献和3篇CCT文献进行meta分析。6项研究显示,切开复位内固定术并发症低于关节融合术(RR=0.53,95%CI0.34～0.83,P=0.005);2种术式在需再次手术及再次手术矫形方面比较无统计学差异(RR=1.16,95%CI0.57～2.37,P=0.68;RR=2.30,95%CI0.73～7.22,P=0.16);关节融合术在内固定物取出方面明显优于切开复位内固定术(RR=6.07,95%CI3.01～12.23,P<0.00001)。治疗效果评分因不同研究采用的评分系统不同,无法进行合并分析。结论在并发症发生率方面,切开复位内固定术优于关节融合术。切开复位内固定术与关节融合术在再次手术和再次手术矫形方面并无差异。在内固定物取出方面,关节融合术要优于切开复位内固定术。Objective To compare the therapeutic effect of primary arthrodesis and open reduction and internal fixation（ORIF）in the treatment of Lisfranc joint injuries.Methods The literatures related to randomized controlled trials or clinical controlled trials of primary arthrodesis and ORIF for treating Lisfranc joint injuries were retrieved and evaluated according to Cochrane criteria.Mata analysis was performed.Results A total of 6 studies,including 3 randomized controlled trials and 3 clinical controlled trials,were qualified for meta analysis.The incidence of complication in ORIF was lower than that in primary arthrodesis（RR=0.53,95% CI 0.34-0.83,P =0.005）.There was no significant difference in second surgery（RR =1.16,95%CI 0.57-2.37,P =0.68）and second orthopedic surgery（RR=2.30,95%CI 0.737.22,P =0.16）.Compared with ORIF,primary arthrodesis was better in removing the internal fixation（RR=6.07,95%CI 3.01-12.23,P 0.000 01）.The therapeutic effect could not be evaluated because the scoring systems were different in these 6 studies.Conclusion The incidence of complication is lower in ORIF,and primary arthrodesis is better in removing the internal fixation,without significant difference in second surgery and second orthopedic surgery between these 2 surgical options.

关 键 词：跖跗关节损伤 切开复位内固定术 关节融合术 META分析 

分 类 号：R683.41[医药卫生—骨科学]