动态外固定架与静态外固定架治疗不稳定桡骨远端骨折远期疗效的Meta分析  

Long- term efficacy of dynamic external fixation versus static external fixation for unstable distal radius fractures:a meta-analysis

作　　者：杨召[1] 马信龙[1,2] 马剑雄[2] 苑珍珍[1] 孙晓雷[1] 邢丹[2] 

机构地区：[1]天津市天津医院骨科,300211 [2]天津医科大学总医院骨科,300052

出　　处：《中国矫形外科杂志》2014年第10期880-885,共6页Orthopedic Journal of China

基　　金：天津市科技支撑重点项目(编号:13ZCZDSY01700;11ZCGYSY01800);天津市卫生局科技攻关项目(编号:11KG137);天津市中医药管理局重点课题(编号:13123)

摘　　要：[目的]系统评价动态外固定架与静态外固定架两种方法治疗不稳定桡骨远端骨折的远期疗效。[方法]计算机检索PubMed,EMBASE,BIOSIS,Springer和Cochrane Library等数据库,纳入关于动态外固定架与静态外固定架两种方法治疗不稳定桡骨远端骨折远期疗效比较的随机对照试验(RCT)。制定入选和剔除标准,筛选出符合纳入标准的文献,评价纳入研究的方法学质量。利用RevMan 5.0(Cochrane Library)进行Meta分析。[结果]共有4篇研究符合纳入标准,共238例患者,动态外固定架组119例,静态外固定架组119例。Meta分析结果显示:动态外固定架与静态外固定架比较,在术后并发症(针道感染及反射性交感神经营养不良)和术后1年患肢临床疗效(旋前、旋后、伸展、屈曲、桡偏及尺偏)方面,两者差异均无统计学意义(P>0.05);而术后1年桡骨长度恢复方面,前者优于后者(P<0.05)。[结论]动态外固定架与静态外固定架治疗不稳定桡骨远端骨折都取得了良好的远期疗效;在术后并发症和术后1年患肢临床疗效方面,两者疗效并无显著差异;但在术后桡骨长度恢复方面,动态外固定架优于静态外固定架。[ Objective] To make a system assessment of the long -term efficacy of dynamic external fixation versus staticexternal fixation for unstable distal radius fractures. [ Method ] A computer -based online search of PubMed, EMBASE, BIOSIS,Springer and Cochrane Library were performed. The randomized and controlled trials of dynamic external fixation versus staticexternal fixation for unstable distal radius fractures were collected. The included trials were screened out strictly based on thecriterion of inclusion and exclusion. The quality of included trials was evaluated. RevMan 5.0 was used for data analysis. [ Result] Four studies involving 238 patients were included. There were 119 patients with dynamic external fixation and 119 withstatic external fixation. The results of Meta - analysis indicated that no difference with regard to the complications postoperatively（pin - track infection and Reflex sympathetic dystrophy） and chnical resuhs （ pronation, supination, flexion, extension, radialdeviation, and ulnar deviation） at one year follow - up were noted. There were statistically significant difference between two ap-proaches with respect to the radial length at one year follow- up（ P 〈 0.05 ）. [ Conclusion] Both dynamic external fixation andstatic external fixation are effective treatment for untstable distal radius fractures. Compared with static external fixation, there areno significant difference in complications postoperatively and clinical results at one year follow - up. With respect to the radiallength at one year follow - up, dynamic external fixation is better than static external fixation.

关 键 词：桡骨远端骨折 动态外固定架 静态外固定架 疗效 META分析 

分 类 号：R687.3[医药卫生—骨科学]