髓内钉固定与钢板固定治疗锁骨中段骨折的Meta分析  

Intramedullary nail fixation versus plate fixation in the treatment of midshaft clavicle fractures:a meta-analysis

作　　者：李磊[1] 朱建华[1] 徐洲[1] 刘玉婷 LI Lei;ZHU Jian-hua;XU Zhou;LIU Yu-ting(Department of Spine surgery,Ninth People′s Hospital of Chongqing,Chongqing 400700,China;Endocrine Department,Ninth People′s Hospital of Chongqing,Chongqing 400700,China)

机构地区：[1]重庆市第九人民医院脊柱外科,重庆400700 [2]重庆市第九人民医院内分泌科,重庆400700

出　　处：《局解手术学杂志》2020年第6期494-500,共7页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的比较髓内钉固定与钢板固定治疗锁骨中段骨折的临床疗效。方法通过计算机在Cochrane Library、PubMed、Embase、OVID、CBM、CNKI、万方和维普等数据库对关于髓内钉固定与钢板固定治疗锁骨中段骨折的随机对照试验进行检索,时限为建库至2020年1月。使用RevMan 5.3软件对检索到的研究进行Meta分析,其中包括肩关节功能评分、上肢功能评分(DASH)、愈合时间、手术时间、切口长度、住院时间、不愈合发生率、内植物失败发生率、再骨折发生率和感染发生率。结果本研究最终纳入8篇随机对照研究,共570例患者。Meta分析结果显示,髓内钉组和钢板组患者在Constant-Murley评分、DASH评分、不愈合发生率、内植物失败发生率和再骨折发生率方面差异无统计学意义(P>0.05);髓内钉组在愈合时间、手术时间、切口长度、住院时间和切口感染方面均优于钢板组,差异有统计学意义(P<0.05)。结论对于锁骨中段骨折的患者,髓内钉固定具有愈合时间更短、手术时间更短、切口长度更小、住院时间更短和切口感染发生率更低等优点,故本研究推荐使用髓内钉固定治疗。Objective To assess the clinical efficacy of intramedullary nail fixation versus plate fixation in the treatment of midshaft clavicle fractures.Methods Conducted a computerized search of the randomized controlled trial on the treatment of midshaft clavicle fracture with intramedullary nail fixation and plate fixation through the databases(such as Cochrane Library,PubMed,Embase,OVID,CBM,CNKI,Wanfang and VIP)up to the end of January 2020.The RevMan 5.3 software was used to conduct the Meta-analysis,including the shoulder function score,upper limb function score(DASH),healing time,operation time,incision length,hospitalization time,nonunion rate,failure rate of implantation,refracture rate and infection rate.Results Eight RCTs with 570 patients were included.Meta-analysis results showed that there was no statistically significant difference between the intramedullary nail group and the plate group in terms of Constant-Murley score,DASH score,incidence of nonunion,incidence of implantation failure and incidence of refracture(P>0.05).The intramedullary nail group was superior to the plate group in terms of healing time,operation time,incision length,hospital stay and incision infection,with statistically significant differences(P<0.05).Conclusion For patients with midshaft clavicular fractures,intramedullary nail fixation can decrease the healing time,operation time,incision length,hospital stay and incidence of incision infection,and this study is more likely to recommend the use of intramedullary nail fixation for treatment.

关 键 词：锁骨中段骨折 髓内钉固定 钢板固定 META分析 临床疗效 

分 类 号：R687.3[医药卫生—骨科学]