| 掌背侧不同入路钢板内固定治疗桡骨远端不稳定骨折疗效的Meta分析 |
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投稿时间：2015-08-07
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| 作者 | Author | 单位 | Address | E-Mail |
| 李业成 |
LI Ye-cheng |
沭阳县人民医院骨科, 江苏 沭阳 223600 |
Department of Laboratory, Shuyang People's Hospital, Shuyang 223600, Jiangsu, China |
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| 张巍 |
ZHANG Wei |
沭阳县人民医院检验科, 江苏 沭阳 223600 |
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zhangwei2003315319@126.com |
| 刘守正 |
LIU Shou-zheng |
沭阳县人民医院骨科, 江苏 沭阳 223600 |
Department of Laboratory, Shuyang People's Hospital, Shuyang 223600, Jiangsu, China |
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| 张成亮 |
ZHANG Cheng-liang |
沭阳县人民医院骨科, 江苏 沭阳 223600 |
Department of Laboratory, Shuyang People's Hospital, Shuyang 223600, Jiangsu, China |
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| 王洪俊 |
WANG Hong-jun |
沭阳县人民医院骨科, 江苏 沭阳 223600 |
Department of Laboratory, Shuyang People's Hospital, Shuyang 223600, Jiangsu, China |
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| 期刊信息：《中国骨伤》2016年，第29卷，第1期，第21-26页 |
| DOI：10.3969/j.issn.1003-0034.2016.01.006 |
| 基金项目: |
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中文摘要:
目的:评价掌背侧不同入路钢板内固定治疗桡骨远端不稳定骨折的临床效果。
方法:计算机检索Medline,Embase,Cochrane Library,CBM,CNKI自1966年至2014年12月发表的掌背侧不同入路钢板内固定治疗桡骨远端不稳定骨折疗效的所有临床随机对照试验,提取资料,对能进行合并分析的研究用RevMan5.0软件进行Meta分析。
结果:纳入6篇随机对照试验,2篇回顾性队列研究,分为掌侧组、背侧组,掌侧组187例,背侧组204例。Meta分析结果显示:与背侧组比较掌侧组在腕关节功能恢复[SMD=0.74,95%CI(0.47,1.01),P<0.000 01],Gartland-Werley 评分[SMD=-1.39,95%CI(-2.24,-0.53),P=0.001],术后神经损伤[OR=3.67,95%CI(1.37,9.84),P=0.01],术后腕关节疼痛[OR=0.32,95%CI(0.13,0.74),P=0.008]方面差异具有统计学意义。但是在术后DASH评分[SMD=-0.36,95%CI(-0.97,0.26),P=0.25],术后影像学结果评估[SMD=-0.18,95%CI(-0.53,0.16),P=0.3],术后握力[SMD=0.71,95%CI(-0.12,1.54),P=0.09],术后肌腱损伤[OR=0.31,95%CI(0.10,0.98),P=0.05],术后腕管综合征[OR=0.96,95% CI(0.63,1.48),P=0.87]方面差异无统计学意义。
结论:与背侧入路钢板内固定比较掌侧入路钢板内固定治疗桡骨远端关节内骨折在关节功能恢复情况具有优势,但术后远期并发症多。 |
| 【关键词】桡骨骨折 骨折固定术,内 外科手术 Meta分析 |
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| Comparison between volar and radial column approach by plate fixation for the treatment of unstable fracture of distal radius:a Meta-analysis |
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ABSTRACT
Objective:To assess the clinical effectiveness of volar and radial column approach by plate fixation for the treatment of unstable fracture of distal radius.
Methods:According to Cochrane Systematic Review,Medline,Embase,Cochrane Library,CNKI and CBM,randomised controlled trials (RCTs) of volar and radial column approach by plate fixation for the treatment of unstable fracture of distal radius were searched for from 1966 to 2014. Data analysis was performed with the Cochrane Collaboration's RevMan 5.0 software.
Results:Totally 391 patients of 6 RCTs and 2 retrospective cohort studys were included and divided into volar plate group(187 cases) and radial column plate group(204 cases). Meta-analysis result showed: compared with radial column plate group,volar plate group had significant difference in recovery of wrist function[SMD=0.74,95%CI(0.47,1.01),P<0.00001],Gartland-Werley scores [SMD=-1.39,95%CI(-2.24,-0.53),P=0.001],postoperative neural injury[OR=3.67,95% CI(1.37,9.84),P=0.01] and postoperative wrist pain[OR=0.32,95%CI(0.13,0.74),P=0.008]. But no significant difference was identified in DASH scores[SMD=-0.36,95%CI(-0.97,0.26),P=0.25],radiographic result assessment[SMD=-0.18,95%CI(-0.53,0.16),P=0.3],postoperative grip strength[SMD=0.71,95% CI(-0.12,1.54),P=0.09],postoperative tendinous damage [OR=0.31,95%CI(0.10,0.98),P=0.05] and carpal tunnel syndrome [OR=0.96,95%CI(0.63,1.48),P=0.87].
Conclusion:Compared with radial column plate internal fixation,volar approach plate fixation for treatment of distal radius intra-articular fracture has advantage of recovery of joint functionand. However,the volar approach plate fixation was associated with a higher risk of long-term complications than the radial column approach plate fixation. |
| KEY WORDS Radius fractures Fracture fixation,internal Surgical procedures,operative Meta-analysis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李业成,张巍,刘守正,张成亮,王洪俊.掌背侧不同入路钢板内固定治疗桡骨远端不稳定骨折疗效的Meta分析[J].中国骨伤,2016,29(1):21~26 |
| 英文格式: | LI Ye-cheng,ZHANG Wei,LIU Shou-zheng,ZHANG Cheng-liang,WANG Hong-jun.Comparison between volar and radial column approach by plate fixation for the treatment of unstable fracture of distal radius:a Meta-analysis[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(1):21~26 |
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