钢板螺钉与髓内钉治疗胫骨远段关节外骨折的Meta分析  

Comparison of intramedullary nail and plate in treatment of extra- articular fractures of distal tibia: a meta-analysis

作　　者：栾富钧[1] 马坤龙[1] 杨帆[1] 邱皓[1] 张铭华[1] 栾和旭 

机构地区：[1]重庆医科大学附属永川医院骨科,402160

出　　处：《中国矫形外科杂志》2015年第16期1465-1470,共6页Orthopedic Journal of China

摘　　要：[目的]比较钢板螺钉与髓内钉治疗胫骨远段关节外骨折的效果。[方法]计算机检索Conchrane、Librar、Pub MED、Embase、CBM、CNKI和维普数据库中关于钢板和髓内钉治疗胫骨远段关节外骨折的随机对照试验,检索时限为建库至2014年12月。同时查阅所获取的参考文献索引。2名研究者对检索收集到的文献按照制定的纳入排除标准进行独立筛选。采用OMAS或者AOFAS、再次手术、初次手术愈合、畸形愈合、深部感染、伤口并发症、局部疼痛或其他不适、手术时间和放射次数或时间作为评价指标。采用Review Manager 5.1软件进行Meta分析。[结果]纳入5篇文献,其中2篇为同一研究的不同时间的随访结果合并为一篇,共有277例患者。结果显示：OMAS、再次手术无统计学差异,初次手术愈合率、畸形愈合率、深部感染、伤口并发症、局部疼痛或其他不适均无统计学差异。仅手术时间有统计学差异（OR：1.05,95%CI：0.48~2.30,P〈0.000 01）。[结论]髓内钉和钢板螺钉治疗胫骨远段骨折功能指标和并发症发生率无明显差异。髓内钉组的手术时间少于钢板螺钉组,但这与术者对手术的熟练程度有关。[Objective ] To compare the results of intramedullary nail and plate in treating the fracture of distal tibia. [ Method ] The data of clinical studies was searched in the following electronic databases, such as Cochrane library, Embase, Pubmed, Chinese Biological Medicine Disc, WeiPu, Wanfang and CNKI database. The Review Manager 5.1 software was used for Meta- analysis. [ Result] Four RCTs were included with 277 cases in all. No statistically significant differences were found in terms of OMAS,second procedures, rate of union, malunion,rate of deep infection, wound problems and local pain. A signifi- cant difference was found in time of operation（ OR： 1.05,95% CI：0.48 - 2.30, P 〈 0. 000 01 ）. [ Conclusion ] Both intramed- ullary nail and plate can treat distal tibial fractures with satisfactory outcomes. But time of operation is shorter with intramedul- lary nail,which is dependent on familiarity and proficiency of surgeon.

关 键 词：META-分析 胫骨远端 髓内钉 钢板螺钉 

分 类 号：R687.3[医药卫生—骨科学]