全螺纹与部分螺纹螺钉固定股骨颈骨折的荟萃分析  

A meta-analysis on full-threaded versus partial-threaded screws for femoral neck fractures

作　　者：刘登科 刘涛涛 谭兴国 高秋明 LIU Deng-ke;LIU Tao-tao;TAN Xing-guo;GAO Qiu-ming(The First Clinical Medical School,Gansu University of Chinese Medicine,Lanzhou,Gansu 730030,China;Department of Trauma and Orthopedics,The 940th Hospital of PLA Joint Logistic Support Force,Lanzhou,Gansu 730050,China)

机构地区：[1]甘肃中医药大学第一临床医学院,甘肃兰州730030 [2]中国人民解放军联勤保障部队第940医院创伤骨科,甘肃兰州730050

出　　处：《中国矫形外科杂志》2025年第3期225-230,共6页Orthopedic Journal of China

基　　金：甘肃省自然科学基金资助项目(编号:21JR11RA001);甘肃省科技基金项目(编号:21JR7RA016)。

摘　　要：[目的]采用荟萃分析方法评价全螺纹螺钉(fully threaded screws,FTS)和部分螺纹螺钉(partially threaded screw,PTS)固定股骨颈骨折的疗效。[方法]检索PubMed、Web of Science、Cochrane Library、Embase、中国知网、万方、维普等数据库,检索时间为2010年1月—2024年5月,阅读全文提取效应量,使用Review Manager 5.4软件进行荟萃分析。[结果]共纳入9篇研究,1篇为随机对照研究,8篇为队列研究。共计778例患者,其中FTS固定组342例,PTS固定组436例。荟萃分析结果显示:FTS固定组颈干角丢失幅度(MD=-1.57,95%CI-2.35~-0.78,P<0.001)、股骨颈短缩率(OR=0.27,95%CI 0.18~0.42,P<0.001)、内固定失败率(OR=0.25,95%CI 0.13~0.48,P<0.001)、退钉率(OR=0.23,95%CI 0.14~0.38,P<0.001)均显著低于PTS组。两组术中出血量、手术时间、骨折愈合时间、股骨头坏死率、骨不连发生率的差异均无统计学意义(P>0.05)。[结论]FTS固定股骨颈骨折与PTS比较,患者颈干角减小幅度更小,而且退钉、股骨颈短缩、内固定失败发生率更低,对于股骨颈骨折,FTS固定比PTS固定更为可靠。[Objective]To compare the clinical efficacy of fully threaded screws(FTS)and partially threaded screws(PTS)for fixation of femoral neck fractures.[Methods]The data bases,including PubMed,Web of Science,Cochrane Library,Embase,CNKI,Wanfang,VIP and others were searched from January 2010 to May 2024 to collect studies comparing the clinical efficacy of FTS and PTS for fixation of femoral neck fractures,and a meta-analysis was performed using Review Manager 5.4 software.[Results]Nine studies were included,involving one randomized controlled study and eight cohort studies.A total of 778 patients were enrolled,including 342 in the FTS fixed group,and 436 in the PTS fixed group.As results of meta-analysis,the FTS was significantly superior to the PTS in terms of femoral neck shortening rate(OR=0.27,95%CI 0.18~0.42,P<0.001),screw withdrawal rate(OR=0.23,95%CI 0.14~0.38,P<0.001),internal fixation failure rate(OR=0.25,95%CI 0.13~0.48,P<0.001),and decline of neck shaft angle(MD=-1.57,95%CI-2.35~-0.78,P<0.001).However,there were no significant differences between the two groups regarding to intraoperative bleeding(MD=2.45,95%CI-6.63~11.54,P=0.60),operation time(MD=1.25,95%CI-0.92~3.42,P=0.26),fracture healing time(MD=0.05,95%CI-0.75~0.86,P=0.89),bone nonunion rate(OR=0.66,95%CI 0.37~1.19,P=0.17),and femoral head necrosis rate(OR=0.65,95%CI 0.32~1.31,P=0.23).[Conclusion]The FTS for internal fixation of femoral neck fractures has less loss in the femoral neck shaft angle,lower incidence of screw retraction,femoral neck shortening,and internal fixation failure than the PTS,therefore,the FTS fixation is more reliable for femoral neck fractures.

关 键 词：股骨颈骨折 全螺纹空心螺钉 部分螺纹空心螺钉 荟萃分析 

分 类 号：R683.42[医药卫生—骨科学]