髓内钉与钢板内固定治疗胫骨远端关节外骨折的Meta分析  

Meta analysis of intramedullary nail versus plate fixation in treatment of extra-articular distal tibial fractures

作　　者：李建刚 王磊[2] 董喆[2] 王凤凤[2] 马改平[3] 刘梅梅[2] 呼芳[2] 

机构地区：[1]子长县人民医院骨科,陕西省子长县717300 [2]延安大学附属医院,骨科四病区,陕西省延安市716000 [3]延安大学附属医院血液免疫科,陕西省延安市716000

出　　处：《中国组织工程研究》2013年第48期8361-8367,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:髓内钉和传统钢板螺丝内固定治疗胫骨远端(关节外)骨折已被广泛应用,但2种方法都有不足之处。一些对照研究试图比较髓内钉与钢板治疗胫骨远端关节外骨折的优劣,但得出的结论各异。目的:对胫骨远端关节外骨折髓内钉与钢板固定的疗效进行Meta分析。方法:计算机检索Pubmed,Embase,Cochrane图书馆及中国生物医学数据库、维普信息数据库、万方数据库,手工检索相关的中英文骨科杂志。收集髓内钉与钢板固定相比较治疗胫骨远端关节外骨折的对照试验,并评价纳入研究的方法学质量。统计软件用Cochrane协作网提供的RevMan 5.0。结果与结论:共纳入4个临床对照试验。与钢板固定治疗胫骨远端关节外骨折相比,髓内钉内固定治疗后的骨折畸形愈合率较高,而骨折不愈合、延迟愈合率和术后感染发生率的差异无显著性意义。说明髓内钉与钢板固定治疗胫骨远端关节外骨折,都能够取得很好的骨折愈合。BACKGROUND： Intramedullary nail and traditional steel plate fixation have been widely used in the treatment of distal tibial（extra-articular） fractures, but these two kinds of methods have shortcomings. Some control studies attempt to answer the advantages and disadvantages of the issue on the treatment of extra-articular distal tibial fractures with intramedullary nail and steel plate fixation, but the conclusions are different. OBJECTIVE： To determine the efficiency and safety of intramedullary nail and plate fixation in the treatment of extra-articular distal tibial fractures by Meta analysis. METHODS： PubMed, Embase, Cochrane Library, CBMdisc, Weipu information database and Wanfang were searched by computer, and relevant Chinese and English orthopedic journals were hand-searched. Controlled trials related to intramedullary nail and plate fixation in the treatment of extra-articular distal tibial fracture were included. The quality of trials was critically assessed. RevMan 5.0 software was used for data analysis. RESULTS AND CONCLUSION： Four articles were included. Meta analysis showed that compared with the plate fixation, the malunion rate of the intramedullary nail for extra-articular distal tibial fractures increased. There was no statistical difference in the rate of nonunion rate, delayed fracture healing, and infection rate after operation. These indicate that intramedullary nail and plate fixation both have good effects on fracture healing.

关 键 词：骨关节植入物 骨与关节循证医学 胫骨远端骨折 关节外骨折 骨折内固定 骨折治疗 髓内钉 钢板 META分析 

分 类 号：R318[医药卫生—生物医学工程]