喙锁韧带重建术和锁骨钩钢板治疗不稳定型锁骨远端骨折效果的Meta分析  

Effect of coracoclavicular ligament reconstruction and clavicular hook plate for the treatment of unstable distal clavicular fracture:a study of Meta-analysis

作　　者：王涛 娄园一 陈周韬 黄勇彬 李丽薇 庞景群 黄春满 陈光华 WANG Tao;LOU Yuanyi;CHEN Zhoutao;HUANG Yongbin;LI Liwei;PANG Jingqun;HUANG Chunman;CHEN Guanghua(Orthopedic Center,Huizhou Sixth People's Hospital,Huizhou 516000,Guangdong,China;Orthopedic Center,Affiliated Hospital of Guangdong Medical University,Zhanjiang 524000,Guangdong,China)

机构地区：[1]惠州市第六人民医院骨科中心,广东省惠州市516000 [2]广东医科大学附属医院骨科中心,广东省湛江市524000

出　　处：《广西医学》2023年第15期1871-1878,共8页Guangxi Medical Journal

基　　金：广东省基础与应用基础研究基金自然科学基金面上项目(2021A1515011434)。

摘　　要：目的系统评价喙锁韧带重建术和锁骨钩钢板治疗不稳定型锁骨远端骨折的效果。方法计算机检索PubMed、The Cochrane Library、Embase、中国知网、万方数据知识服务平台、维普网、中国生物医学文献服务系统等数据库,纳入喙锁韧带重建术和锁骨钩钢板治疗不稳定型锁骨远端骨折的相关文献。根据纳入和排除标准筛选符合要求的文献,进行文献质量评价后提取有效数据,采用RevMan 5.4软件进行Meta分析。结果共纳入23篇文献,共1119例患者。Meta分析结果显示,喙锁韧带重建术治疗不稳定型锁骨远端骨折在肩关节Constant-Murley评分、美国肩肘外科协会(ASES)评分、术后疼痛视觉模拟量表评分、术后并发症发生率、伤口长度等方面均优于锁骨钩钢板治疗,但前者手术时间更长(P<0.05),两种手术方式的术中出血量差异无统计学意义(P>0.05)。结论采用喙锁韧带重建术治疗不稳定型锁骨远端骨折在恢复肩关节功能、减轻术后肩关节疼痛、降低术后并发症发生率、获得伤口美观度方面均优于锁骨钩钢板治疗,但前者手术时间更长,而两种手术方式的术中出血量相当。Objective To systematically evaluate the effect of coracoclavicular ligament reconstruction and clavicular hook plate for the treatment of unstable distal clavicular fracture.Methods The databases of PubMed,The Cochrane Library,Embase,China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,VIP,Chinese Biomedical Literature Service System,etc.,were retrieved by computer,the literature related to coracoclavicular ligament reconstruction and clavicular hook plate for the treatment of unstable distal clavicular fractures was enrolled.According to the inclusion and exclusion criteria,the eligible literature was screened,after the evaluation of the literature quality,the effective data were extracted.The RevMan 5.4 software was used for Meta-analysis.Results A total of 23 literature was enrolled,involving 1119 patients.The results of Meta-analysis revealed that coracoclavicular ligament reconstruction for the treatment of unstable distal clavicular fracture exerted superior aspects of shoulder joint Constant-Murley score,American Shoulder and Elbow Surgeons(ASES)score,postoperative Visual Analogue Scale score for pain,incidence rate of postoperative complications,and wound length to compare with clavicular hook plate therapy,but the former exhibited longer operation duration(P<0.05).There was no statistically significant difference in intraoperative bleeding volume between the two surgical methods(P>0.05).Conclusion Coracoclavicular ligament reconstruction for the treatment of unstable distal clavicular fractures is superior to clavicular hook plate in terms of restoring shoulder joint function,relieving postoperative shoulder joint pain,decreasing the incidence rate of postoperative complications,and obtaining wound aesthetics,but the former exhibits longer operation duration,whereas intraoperative bleeding volume is similar between the two surgical methods.

关 键 词：锁骨远端骨折 不稳定型 喙锁韧带重建术 锁骨钩钢板 效果 META分析 

分 类 号：R683.411[医药卫生—骨科学]