闭合复位经皮克氏针固定治疗儿童伸直型肱骨髁上骨折-内外侧穿针与单纯外侧穿针的疗效比较  

Medial-lateral entry pinning versus lateral entry pinning for extension supracondylar fractures of the humerus:a meta-analysis of randomized controlled trials

作　　者：丁晓飞[1] 廖世杰[1] 赵劲民[1] 姚军[1] 苏伟[1] 韦庆军[1] 

机构地区：[1]广西医科大学第一附属医院创伤手外科,530021

出　　处：《中国矫形外科杂志》2012年第12期1067-1071,共5页Orthopedic Journal of China

基　　金：广西自然科学基金项目(编号:2010GXNSFA013161)

摘　　要：[目的]采用系统评价的方法比较内外侧交叉与单纯外侧经皮克氏针固定术治疗儿童伸直型肱骨髁上骨折的疗效及安全性。[方法]检索内外侧交叉与单纯外侧经皮克氏针固定术治疗儿童肱骨髁上骨折的随机对照试验,严格评价纳入研究的方法学质量并提取资料。采用RevMan 5.1软件行Meta分析。[结果]共纳入5个随机对照试验。资料分析显示,内外侧置针与单纯外侧置针两种技术在尺神经损伤发生率上存在统计学差异[RR=3.31,95%CI(1.04,10.52),P=0.04],在提携角丢失值、Baumann角丢失值、前倾角丢失值、针道感染率及Flynn肘关节功能评分优良率方面均无统计学意义。[结论]闭合复位经皮内外侧置针技术治疗儿童伸直型肱骨髁上骨折尺神经损伤发生率比单纯外侧置针技术高,在复位后机械稳定性、肘关节功能及针道感染率方面两者疗效相当。[ Objective] To compare the efficacy of medial-lateral entry pinning versus lateral entry pinning for extension su- pracondylar fractures of the humerus in children. [ Method] We searched and collected andomized controlled trials （RCTs） of medial-lateral entry pinning for extension snpracondylar fractures of the humerus in children. The quality of the included studies was critically assessed and relative data were extracted. Data analyses were performed with the statistical software Revman 5.1. [ Result] Five RCTs were included. The results of meta-analysis showed that there were statistically significant differences in ul- nar nerve injury incidence[ RR = 3.31,95% CI（1.04,10.52） ,P = 0.04] between medial-lateral entry pinning and lateral entry pinning groups. And no statistically significant difference was found in carrying angle loss, Baumann angle loss, humerocapitellar angle loss, pin-track infection incidence, rate of excellent or good outcome by flynn criteria. [ Conclusion] This research shows that ulnar nerve injury incidence in medial-lateral entry pinning group is higher than lateral entry pinning group, and the equiva- lent curative effect is found in mechanical stability, pin-track infection incidence, rate of excellent or good outcome by flynn cri- teria between the two groups.

关 键 词：髁上骨折 克氏针固定 随机对照试验 meta分析 儿童 

分 类 号：R726.8[医药卫生—儿科]