切开与闭合复位内固定治疗股骨颈骨折并发症的meta分析  

The complication of open reduction and closed reduction internal fixation in treatment of femoral neck fractures: a meta-analysis

作　　者：王辰[1,2] 马信龙[1,3] 马剑雄[1] 孟德旺[4] 王颖[1] 张弢[3] 汪松[3] 姜轩[3] 吕广水 

机构地区：[1]天津医院骨科研究所生物力学实验室,300211 [2]天津医科大学,300070 [3]天津医科大学总医院,300352 [4]天津市胸科医院心脏内科,300051

出　　处：《实用医学杂志》2015年第2期275-278,共4页The Journal of Practical Medicine

基　　金：吴阶平基金会临床科研专项资助基金(编号:320.6750.11017)

摘　　要：目的：应用meta分析评价股骨颈骨折切开复位内固定与闭合复位内固定对股骨头坏死及骨折愈合率的影响。方法：计算机检索PubMed、EMBASE、中国生物医学文献数据库等医学文献数据库所有关于股骨颈骨折切开与闭合复位内固定治疗的随机对照研究（randomized controlled trial．RCT）或回顾性对照研究ease-controlled trial，CCT），截止到2014年4月。采用RevMan5．1软件进行统计分析。结果：共14篇文献纳入标准，其中RCT5篇，CCT9篇，meta分析结果显示，股骨头坏死率与两种术式有显著差异（OR=0．57，95％CI：0．38—0．86，P=0．008），而骨折愈合率与两种术式没有显著差异（OR=1．17，95％CI：0．79—1．75，P=0．43）。结论：闭合复位内固定术后股骨头坏死率高于切开复位内固定，而骨折愈合率与两种术式无显著差异。Objective A meta-analysis was performed to assess the association between healing rate, avascular necrosis of femoral head and two reductions-open reduction internal fixation（ORIF）and closed reduction internal fixation （CRIF） for femoral neck fracture. Methods Studies were identified by computer from Medline （1966-2014.4）, PubMed （1966.1-2014.4）, EMBAESE （1966.1-2014.4）, Science （1990.1-2014.4）, CBM （ 1978- 2014.4） and VIP （1978-2014.4）, relevant journals or conference proceedings were also searched manually. The authors enrolled RCT and CCT. The odd ratio （OR） and 95% confidence interval （CI） were used for estimating the effects of the two reduction methods. Data were independently extracted by two investigators who reached a consensus on all of the items. The heterogeneity between studies was examined by X2 -based Q statistic. Then the data were extracted and a Meta-analysis was made using RevManS.1. Results We examined 14 publications. The results of the present meta-analysis showed that AVN of femoral head was significant associated with the two reductions （OR = 0.57, 95%CI：0.38 - 0.86, P = 0.008）, while the healing rate was not （OR = 1.17, 95%CI： 0.79 - 1.75, P = 0.43）. Conclusion The present meta-analysis indicates that the risk of AVN of femoral head is significant higher after CRIF fixation compared with ORIF, but no association between the healing rate and the two reductions for femoral neck fracture.

关 键 词：股骨颈骨折 切开复位 闭合复位 内固定 META分析 

分 类 号：R687.3[医药卫生—骨科学]