骨盆骨折分型方法及其一致性的系统综述  

Systematic review of classification methods and reliability of pelvic fractures

作　　者：陈依民 孙旭 杨明辉 刘刚 吴新宝 Chen Yimin;Sun Xu;Yang Minghui;Liu Gang;Wu Xinbao(Department of Trauma and Orthopaedics,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China)

机构地区：[1]首都医科大学附属北京积水潭医院创伤骨科,100035

出　　处：《骨科临床与研究杂志》2024年第4期240-248,共9页Journal Of Clinical Orthopedics And Research

基　　金：北京积水潭医院“学科骨干”计划专项经费资助项目(XKGG202102)。

摘　　要：目的通过系统综述方法回顾既往骨盆骨折的分型方法并对其可靠性进行总结。方法根据系统评价和荟萃分析首选报告项目(PRISMA)指南通过计算机检索PubMed、Embase、Web of Science等数据库,检索时限均从各数据库建库到2023年12月。搜集关于骨盆骨折分型及其可靠性评价的文献,由2名研究者根据纳入和排除标准独立筛选并提取文献数据。采用纽卡斯尔-渥太华量表(the Newcastle-Ottawa scale,NOS)对纳入非随机对照研究的质量进行评估。结果最初从数据库中检索到7136篇文献,经筛查后最终纳入文献32篇,其中25篇文献与提出新的骨盆骨折分型有关(A组),7篇比较了骨盆骨折分型方法的一致性(B组)。A组中20篇文献为回顾性队列研究,5篇为综述;B组7篇文献均为回顾性队列研究。文献质量评价结果显示,A组NOS评分≥5分的文献占比90.0%(18/20),评分>5分且<8分的文献占比55.0%(11/20),评分≥8分的文献占比10.0%(2/20),文献总体质量较好。A组25篇文献总计提出23种骨盆骨折分型方法,所有分型系统均考虑骨盆骨折的稳定性,15种分型方法考虑了受伤时骨盆的受力机制,20种分型方法具有分级。在分型一致性评价方面,6篇文献比较了AO/OTA分型一致性,5篇文献比较了Young-Burgess分型的一致性,2篇文献比较了Rommens骨盆环脆性骨折分类的一致性。无论是观察者内部一致性还是外部一致性,分型/分类的一致性明显高于分亚型的一致性;Young-Burgess分型在观察者内部一致性方面稍优于AO/OTA分型。结论至今已有23种骨盆骨折分型方法被提出,其中Young-Burgess分型和Tile分型在临床上最为常用。虽然这些方法在一致性上表现良好,但随着复位机器人和计算机导航骨盆骨折内固定技术的出现,骨盆骨折的治疗方式已经发生了革命性的转变。现有的分类方法难以满足手术机器人的数据需求,更智能、数字化且易于机器理�Objective To review the classification methods of previous pelvic fractures and summarize their reliability through a systematic review method.Methods According to the preferred reporting items(PRISMA)guidelines for systematic evaluation and meta-analysis,databases such as PubMed,Embase,and Web of Science were searched using computers,with retrieval times ranging from database establishment to December 2023.Collecting literature on the classification andreliability evaluation of pelvic fractures,and had two researchers independently screen and extract literature data based on inclusion and exclusion criteria.TheNewcastle Ottawa Scale(NOS)was used to evaluate the quality of inclusion in non-randomized controlled studies.Results Initially,7136 articles were retrieved from the database,and after screening,32 articles were ultimately included.Among them,25 articles were related to the proposed new classification of pelvic fractures(Group A),and 7 articles compared the consistency of the classification methods for pelvic fractures(Group B).20 articles in Group A are retrospective cohort studies,and 5 articles are reviews.The 7 articles in Group B were all retrospective cohort studies.The literature quality evaluation results showed that 90.0%(18/20)of the literature in Group A had a NOS score of≥5,55.0%(11/20)had a score of>5 but<8,and 10.0%(2/20)had a score of≥8.The overall quality of the literature was good.A total of 23 classification methods for pelvic fractures were proposed in Group A.All classification systems considered the stability of pelvic fractures,15 classification methods considered the force mechanism of the pelvis during injury,and 20 classification methods were graded.In terms of classification consistency evaluation,6 articles compared the AO/OTA classification consistency,5 articles compared the Young Burgess classification consistency,and 2 articles compared the Rommens pelvic ring fragility fracture classification consistency.Whether it is internal consistency or external consistency among ob

关 键 词：骨盆骨折 分型 创伤骨科 

分 类 号：R683.3[医药卫生—骨科学]