髓内固定与钢板固定治疗锁骨中段骨折的Meta分析  

Meta-analysis of intramedullary fixation and plate fixation in the treatment of midshaft clavicle fracture

作　　者：邱皓 陈渝[1] 朱云 刘盾[1] 靳国荣 吴秀丽[2] Qiu Hao;Chen Yu;Zhu Yun;Liu Dun;Jin Guorong;Wu Xiuli(Trauma Orthopaedics and Hand,Foot and Ankle Surgery Dept.,The Ninth People's Hospital of Chongqing,Chongqing 400700,China;Physical Examination Center,The Ninth People's Hospital of Chongqing,Chongqing 400700,China)

机构地区：[1]重庆市第九人民医院创伤骨科与手足踝外科,重庆400700 [2]重庆市第九人民医院体检中心,重庆400700

出　　处：《保健医学研究与实践》2022年第12期44-52,共9页Health Medicine Research and Practice

基　　金：重庆市第九人民医院院级课题(2020YJXM10)。

摘　　要：目的 探讨髓内固定与钢板固定治疗锁骨中段骨折的临床疗效。方法 计算机检索Pub Med、Cochrane Library、Embase、中国期刊网全文数据库、万方和维普数据库中关于髓内固定与钢板固定治疗锁骨中段骨折的随机对照研究(RCT)文献,检索的时限为建库至2022年7月。通过Rev Man 5.3软件对纳入文献进行质量评价及分析。结果 研究最终纳入14篇RCT,共1 122例患者。Meta分析结果显示:采用髓内固定者与采用钢板固定者在肩关节功能评分方面的差异无统计学意义(P>0.05);但在上肢功能评分(DASH评分)、手术时间、切口长度、住院时间、切口感染、术中出血量、愈合时间等方面,采用髓内固定者的数据均优于采用钢板固定者,且差异均有统计学意义(P<0.05)。结论 对于锁骨中段骨折的患者,采用髓内固定者和采用钢板固定者在术后能获得相似的肩关节功能,而采用髓内固定者较采用钢板固定者手术时间更短、切口更小、住院时间更短、切口感染发生率更低、术中出血量更少、愈合时间更短。Objective To investigate the clinical effect of intramedullary fixation and plate fixation in the treatment of midshaft clavicle fracture.Methods PubMed,Cochrane Library,Embase,Chinese Journal Full-text Database,Wanfang,and VIP databases were searched by computer for randomized controlled trials(RCTs) on intramedullary fixation and plate fixation in treating midshaft clavicle fractures from database establishment to July 2022.The quality of the included articles was evaluated and analyzed using Rev Man 5.3 software.Results Fourteen RCTs with a total of 1 122 patients were finally included in the study.Meta-analysis showed that there was no significant difference in shoulder joint function score between patients treated with intramedullary fixation and plate fixation(P>0.05).However,in terms of upper limb function score(DASH score),operation time,incision length,hospital stay,incision infection,intraoperative blood loss,and healing time,the data of patients treated with intramedullary fixation were better than those treated with plate fixation,with statistically significant differences(P<0.05).Conclusion For patients with midshaft clavicle fractures,intramedullary fixation,and plate fixation can obtain similar shoulder joint function after the operation;while intramedullary fixation has shorter operation time,smaller incision,shorter length of hospital stay,lower incidence of incision infection,smaller intraoperative blood loss and shorter healing time than plate fixation.

关 键 词：髓内固定 钢板固定 锁骨中段骨折 META分析 

分 类 号：R687.3[医药卫生—骨科学]