闭合复位克氏针内固定和切开复位克氏针内固定治疗儿童GartlandⅢ型肱骨髁上骨折的疗效对比meta分析  

Open reduction vs closed reduction and pinning in treatment of typeⅢ supracondylar humeralfractures in children：a meta-analysis

作　　者：马德涛 袁宝明[1] 张子言[1] 康立恒 崔铭毓 吴丹凯[1] 

机构地区：[1]吉林大学第二医院创伤外科,长春130000

出　　处：《中国医师进修杂志》2017年第12期1103-1108,共6页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 通过meta分析的方法比较闭合复位克氏针内固定和切开复位克氏针内固定治疗GartlandⅢ型骨折之间的疗效差异.方法 通过PICOS法检索闭合复位克氏针内固定和切开复位克氏针内固定治疗GartlandⅢ型骨折的对照性研究,共检索出6篇文献,析取数据后采用Stata软件进行meta分析,评定闭合组与切开组在术后外形、功能及神经损伤方面的差异.结果外形对比：OR=0.92,P=0.760;功能对比：OR=1.69,P=0.55;术后尺神经损伤对比：OR=1.10, P=0.332.未得到差异有统计学意义的结果,但发现闭合组在术后功能方面具有明显的优势性趋势.结论 应尽量采用闭合复位克氏针内固定的方式进行GartlandⅢ型的治疗,但对于某些骨折类型复杂、肿胀程度严重、就诊时间较晚、闭合复位困难的患者,可进行1~2次的闭合复位,如果失败则选择切开复位克氏针内固定的方式治疗.Objective To assess the effects of two different managements of typeⅢsupracondyla humeral fractures in children： open reduction vs closed reduction and pinning. Methods Relevant articles were identified by using several database （Pubmed Medline, EMbase, cochranelibrary, CBM, CNKI, wanfang data）. Control studies comparing closed reduction with percutaneous pinning and open reduction with pinning were analyzed.Results There was no significant difference in the carrying angle according to criteria of Flynn（OR=0.92,P=0.760）.There was no significant difference in the functional results according to criteria of Flynn（OR=1.77, P=0.557）.There was no significant difference in the ulnar nerve injury（OR=1.10,P=0.332）.However, there was a obvious tendency to excellent and good results in the closed reduction group. Conclusions We recommend that closed reduction with percutaneous pinning should be performed first unless some special circumstances are present, for example：complex fractures and failed closed reduction.

关 键 词：肱骨骨折 内固定器 切开复位 

分 类 号：R726.8[医药卫生—儿科]