经跗骨窦切口与外侧L形切口内固定治疗Sanders Ⅱ、Ⅲ型跟骨骨折的Meta分析  

Comparison of extensile lateral approach and sinus tarsi approach in treating displaced intra-articular calcaneal fractures: a meta-analysis

作　　者：赵星[1] 祝少博[1] 余黎[1] 邓宇[1] 邓玲珑[1] ZHAO Xing;ZHU Shao-bo;YU Li;DENG Yu;DENG Lin-long(Department of Orthopedics, Zhongnan Hospital of Wuhon University, Wuhan, Hubei 430071, China)

机构地区：[1]武汉大学中南医院骨科中心,湖北武汉430071

出　　处：《中国骨与关节损伤杂志》2018年第4期368-370,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的采用Meta分析比较经跗骨窦切口与外侧L形切口内固定治疗Sanders Ⅱ、Ⅲ型跟骨骨折的临床效果。方法系统检索Pub Med、EMbase、Central、维普数据库、中国知网数据库和万方数据库,查找所有比较经跗骨窦切口(试验组)和外侧L形切口(对照组)内固定治疗Sander Ⅱ、Ⅲ型跟骨骨折的随机对照试验或临床对照研究。采用Cochrane协作网提供的Rev Man 5.3软件进行Meta分析。结果最终纳入11篇文献,其中随机对照试验3篇,观察性研究8篇;共1 224例,试验组604例,对照组620例。Meta分析结果显示,与对照组比较,试验组受伤至手术时间、手术时间、切口长度更短,术中出血量更少,术后Gissane角恢复更为满意,末次随访时AOFAS评分更高,术后切口感染、切口边缘坏死、腓肠神经损伤发生率更低,差异有统计学意义(P<0.05)。结论与外侧L形切口内固定治疗Sanders Ⅱ、Ⅲ型跟骨骨折比较,经跗骨窦切口内固定可以缩短术前等待时间及手术时间,缩短切口长度,减少术中出血量,降低术后早期切口并发症,而且术后踝关节功能恢复更为满意。Objective To evaluate the extensile lateral approach（ELA）versus the sinus tarsi approach（STA）in treating displaced intra-articular calcaneal fractures（DIACF）by evidence-based medicine.Methods Databases of PubMed,Cochrane Central Register of Controlled Trials（CENTRAL）,EMbase,the ISI web of knowledge databases,VIP aatabase for Chinese technical periodicals,China national knowledge infrastructure（CNKI）,Chinese biomedical literature database（CBM）and Wanfang data were searched from their establishment to October 2017 to collect the controlled clinical trial about ELA vs STA for the treatment of the DIACF.After study selection,assessment and data extraction were conducted by two reviewers independently and separately.A recta-analysis was performed by using the RevMan 5.3 software.Results Eleven studies,3 RCTs and 8 CCTs,involving 1 224 patients were included,with 604 patients in the STA group and 620 in the STA group.The results of meta-analyses showed that：coalpared with the ELA,the STA had shorter time from injury to surgery,shorter operation time,less intraoperative bleeding,lower complication rates including the wound infection ,wound-edge necrosis and the injury of nerve,better in Gissane angle and AOFAS score.Conclusion Compared with the ELA in treating displaced intra-articular calcaneal fractures,the STA is safer and more effective in term of operation time,intraoperative bleeding,time from injury to surgery and complication rates,and the recovery of function of the ankle is better.

关 键 词：SandersⅡ、Ⅲ型跟骨骨折 外侧L形切口 经跗骨窦切口 内固定 META分析 

分 类 号：R687.3[医药卫生—骨科学]