双反牵引与切开复位治疗胫骨平台骨折的Meta分析  

Double reverse traction versus open reduction for tibial plateau fractures:A Meta-analysis

作　　者：梁浩 霍宇航 王霜 丛龙旭 范小龙 王玉路[1] LIANG Hao;HUO Yu-hang;WANG Shuang;CONG Long-xu;FAN Xiao-long;WANG Yu-lu(Department of Trauma,the First Affiliated Hospital of Baotou Medical College,Inner Mongolia Autonomous Region,Baotou 014010,China;The First Clinical School of Inner Mongolia Medical University,Hohhot 010110,China)

机构地区：[1]包头医学院第一附属医院创伤一科,内蒙古包头014010 [2]内蒙古医科大学第一临床医学院,内蒙古呼和浩特010110

出　　处：《河北医科大学学报》2025年第3期309-316,共8页Journal of Hebei Medical University

基　　金：内蒙古自治区自然科学基金项目(2018MS08142);包头医学院青年支持计划项目(BYJJ-QNGG 2022035);包头医学院研究生科研创新项目(BYKYCX202401)。

摘　　要：目的比较双反牵引辅助微创闭合复位接骨板内固定术和切开复位接骨板内固定术治疗胫骨平台骨折的治疗效果。方法构建检索式分别检索PubMed、Cochrane Library、Embase、Web of Science、中国知网、万方、维普及中国生物医学文献服务系统等数据库,收集双反牵引微创闭合复位和切开复位治疗胫骨平台骨折的文献,检索时间为建库至2024年4月。文献质量评价和数据提取由2位研究人员各自提取,对所提数据使用RevMan 5.3软件进行分析。结果本研究共纳入文献7篇,总纳入患者511例,其中微创组患者234例,切开组患者277例。结果显示,微创组在术中出血量[MD=-2.55,95%CI:-3.94~1.17,P<0.01]、住院时间[MD=-0.54,95%CI:-0.75~-0.33,P<0.01]、美国特种外科医院(The Hospital for Special Surgery,HSS)评分[MD=0.71,95%CI:0.50~0.91,P<0.01]、骨折愈合时间[MD=-0.39,95%CI:-0.70~-0.08,P=0.01]、并发症发生率[OR=0.30,95%CI:0.16~0.57,P<0.01]和切口并发症[OR=0.26,95%CI:0.10~0.68,P=0.006]优于切开组,2组在手术时间[MD=0.03,95%CI:-1.54~1.61,P>0.05]、术后负重时间[MD=-0.92,95%CI:-2.14~-0.30,P=0.14]、下肢深静脉血栓发生率[OR=0.78,95%CI:0.31~2.00,P=0.61]方面差异无统计学意义。结论双反牵引辅助微创闭合复位接骨板固定术治疗胫骨平台骨折治疗效果优于切开复位接骨板内固定术。Objective To compare the therapeutic outcomes of double reverse traction-assisted minimally invasive closed reduction with plate fixation and open reduction with plate fixation in the treatment of tibial plateau fractures.Methods Constructed search equations to search across databases such as PubMed,Cochrane Library,EMbase,Web of Science,and Chinese databases including CNKI,Wanfang,VIP,and the China Biomedical Literature Service System for literature on the treatment of tibial plateau fractures via double reverse traction-assisted minimally invasive closed reduction and open reduction.The timeframe for our search was from the inception of these databases until April 2024.Two separate researchers conducted the literature quality assessment and data extraction,with data analysis performed using RevMan 5.3 software.Results Our study encompasses seven articles,involving a total of 511 patients,of whom 234 were treated with the minimally invasive method and 277 with the open reduction method.The findings indicated that the minimally invasive group demonstrated superior outcomes in terms of intraoperative blood loss(MD=-2.55,95%CI:-3.94--1.17,P<0.01),length of hospitalization(MD=-0.54,95%CI:-0.75--0.33,P<0.01),Hospital for Special Surgery(HSS)score(MD=0.71,95%CI:0.50-0.910,P<0.01),fracture healing time(MD=-0.39,95%CI:-0.70--0.08,P=0.01),incidence of complications(OR=0.30,95%CI:0.16-0.57,P<0.01),and wound complications(OR=0.26,95%CI:0.10-0.68,P=0.006)when contrasted with the open reduction group.However,both techniques showed comparable duration of operation(MD=0.03,95%CI:-1.54-1.61,P>0.05),postoperative weight-bearing time(MD=-0.92,95%CI:-2.14--0.3,P=0.14)or the incidence of deep vein thrombosis in the lower limbs(OR=0.78,95%CI:0.31-2.00,P=0.61).Conclusion Double reverse traction-assisted minimally invasive closed reduction plate fixation presents enhanced efficacy in the management of tibial plateau fractures relative to open reduction withplate internal fixation.

关 键 词：胫骨骨折 双反牵引装置 微创闭合复位 

分 类 号：R683.42[医药卫生—骨科学]