弹性髓内钉固定与钢板固定治疗锁骨中段骨折的Meta分析  

Elastic stable intramedullary nailing versus plate fixation for midshaft clavicular fractures: A Meta-analysis

作　　者：陈浩[1] 张锦洪[1] 贺增良[1] 

机构地区：[1]东南大学附属第二医院骨科,江苏省南京市210003

出　　处：《中国组织工程研究》2013年第13期2407-2414,共8页Chinese Journal of Tissue Engineering Research

摘　　要：背景:对于弹性髓内钉固定和钢板固定,选择何种方法治疗锁骨中段骨折疗效满意,目前尚未达成共识,且当前的研究仅限于小样本研究,很难做到大样本多中心治疗观察分析。目的:用Meta分析的方法评价弹性髓内钉固定与钢板固定治疗锁骨中段骨折的疗效及安全性。方法:计算机检索PubMed、EMbase、Cochrane Library(2012年第1期),CBM、CNKI、VIP和万方数据库,并手工检索相关领域杂志,时间从建库至2012年3月。搜集关于弹性髓内钉固定与钢板固定治疗锁骨中段骨折的对照研究,由两名评价员独立选择试验、提取资料,并进行质量评价。结果与结论:最终纳入1项随机对照试验,4项回顾性队列研究试验,共388例患者。Meta分析结果显示,弹性髓内钉固定组术后功能恢复Constant评分高于钢板固定组(P<0.01)。在骨折平均愈合时间、手术时间、切口长度、术中出血量及住院时间等方面弹性髓内钉固定组少于或小于钢板固定组(P<0.01)。在并发症发生率方面,骨不连、内置物固定失败、切口感染和骨折畸形愈合等方面两组差异无显著性意义。现有证据表明,弹性髓内钉固定治疗锁骨中段骨折疗效优于钢板固定,在并发症发生率方面两种方法差异无显著性意义,但上述结果尚需高质量的随机对照试验进一步验证。BACKGROUND： This is no consensus on the choice of elastic stable intramedullary nailing or plate fixation for the treatment of midshaft clavicular fractures. Current research is limited to a small sample studies, and it is difficult to carry out a large-sample multicenter analysis.OBJECTIVE： To evaluate the efficacy and safety of elastic stable intramedullary nailing and plate fixation for the treatment of midshaft clavicular fractures with Meta-analysis.METHODS： The PubMed database, EMbase database, Cochrane Library, CBM database, CNKI database, VIP database and Wangfang database were searched with computer to collect the controlled trials of elastic stable intramedullary nailing versus plate fixation for midshaft clavicular fractures, and related Chinese journals were manually searched. The searching time ranged from the date of database establishment to March 2012. The trails were selected, the data were extracted and the quality was evaluated by two investigators independently.RESULTS AND CONCLUSION： One randomized controlled trial and four retrospective controlled trials involving 388 patients were included in our Meta-analysis. The results showed the postoperative functional recovery Constant score of the elastic stable intramedullary nailing group was higher than that of the plate fixation group （P 〈 0.01）. The average bone union time, operation time, incision length, intraoperative blood loss and the hospital stay of the elastic stable intramedullary nailing group were less than those of the plate fixation group （P 〈 0.01）. There were no significant differences in incidence rate of complications, nonunion, implant failure, wound infection and malunion between two groups. Based on the current evidence, elastic stable intramedullary nailing for the treatment of midshaft clavicular fractures is superior to the plate fixation in the efficacy. There is no significant difference of incidence rate of complications between elastic stable intramedullary nailing and plate fixation. The results s

关 键 词：骨关节植入物 骨关节植入物循证医学 锁骨 骨折 钢板 髓内钉 骨折愈合 骨不连 感染 畸形愈合 安全性 META分析 

分 类 号：R318[医药卫生—生物医学工程]