| 克氏针与弹性髓内钉固定治疗儿童肱骨近端骨折Meta分析 |
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Received:December 09, 2024
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| 作者 | Author | 单位 | Unit | E-Mail |
| 施涛 |
SHI Tao |
金华市妇幼保健院小儿骨科, 浙江 金华 321000 |
Department of Pediatric Orthopedic Surgery, Jinhua Maternity and Child Health Care Hospital, Jinhua 321000, Zhejiang, China |
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| 徐子航 |
XU Zi-hang |
金华市妇幼保健院小儿骨科, 浙江 金华 321000 |
Department of Pediatric Orthopedic Surgery, Jinhua Maternity and Child Health Care Hospital, Jinhua 321000, Zhejiang, China |
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| 张鑫 |
ZHANG Xin |
金华市妇幼保健院小儿骨科, 浙江 金华 321000 |
Department of Pediatric Orthopedic Surgery, Jinhua Maternity and Child Health Care Hospital, Jinhua 321000, Zhejiang, China |
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| 钱宇望 |
QIAN Yu-wang |
金华市妇幼保健院小儿骨科, 浙江 金华 321000 |
Department of Pediatric Orthopedic Surgery, Jinhua Maternity and Child Health Care Hospital, Jinhua 321000, Zhejiang, China |
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| 朱磊 |
ZHU Lei |
金华市妇幼保健院小儿骨科, 浙江 金华 321000 |
Department of Pediatric Orthopedic Surgery, Jinhua Maternity and Child Health Care Hospital, Jinhua 321000, Zhejiang, China |
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| 孔来法 |
KONG Lai-fa |
金华市妇幼保健院小儿骨科, 浙江 金华 321000 |
Department of Pediatric Orthopedic Surgery, Jinhua Maternity and Child Health Care Hospital, Jinhua 321000, Zhejiang, China |
jhyyklf@163.com |
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| 期刊信息：《中国骨伤》2025年38卷，第6期，第633-640页 |
| DOI：10.12200/j.issn.1003-0034.20240599 |
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目的：通过Meta分析系统评价克氏针与弹性髓内钉固定治疗儿童肱骨近端骨折的临床疗效。
方法：检索万方数据库、VIP、CNKI、中国生物医学文献数据库(China biology medicine,CBM)、PubMed、Embase、Web of Science数据库建库至2023年10月发表的关于克氏针与弹性髓内钉治疗儿童肱骨近端骨折的文献。采用Endnote X9和Excel2019进行文献提取、管理及数据录入,并采用RevMan 5.3软件进行Meta分析。比较两组手术时间、住院时间、骨折愈合时间、肩关节伸展活动度、臂肩手功能障碍问卷评分(disabilities of arm,shoulder and hand,DASH),Neer评分或Con-stant-Murley评分及并发症情况。
结果：共纳入7篇文献,1篇为前瞻性研究,6篇为回顾性队列研究,共521例患儿,其中克氏针组264例,弹性髓内钉257例。Meta分析结果显示,两组手术时间[WMD=-12.61,95% CI (-24.89,-0.33),P=0.04]、骨折愈合时间[WMD=-0.26,95% CI (-0.49,-0.02),P=0.03]、总体并发症发生率[OR=6.83,95% CI (3.33,14.01),P<0.001]、钉道感染[OR=6.77,95% CI (1.72,26.69),P=0.006]、骨折移位[OR=3.57,95% CI (1.35,9.44),P=0.01]比较,差异有统计学意义。两组住院时间、肩关节伸展活动度、DASH评分,Neer评分及Constant-Murley评分、皮肤激惹比较,差异无统计学意义(P>0.05)。
结论：克氏针内固定术手术时间短,操作简单,但较弹性钉内固定技术具有更高的并发症发生率。就疗效和安全性而言,弹性髓内钉固定是治疗儿童肱骨近端骨折的选择之一。 |
| [关键词]:肱骨近端骨折 克氏针 弹性髓内钉 并发症 Meta 分析 |
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| Meta analysis of Kirschner's needle and elastic intramedullary nail fixation for the treatment of proximal humeral fractures in children |
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Abstract:
Objective To systematically evaluated clinical efficacy of Kirschner's needle and elastic intramedullary nail fixation in treating proximal humeral fractures in children by Meta-analysis.
Methods Literature on the treatment of proximal humeral fractures in children with Kirschler needles and elastic intramedullary nails published on Wanfang,VIP,CNKI and China biology medicine (CBM),PubMed,Embase,and Web of Science databases were searched from the establishment of databases to October,2023. Literature extraction,management and data entry were performed by Endnote X9 and Excel 2019, and Meta-analysis was conducted by RevMan 5.3 software. The operation time,hospital stay,fracture healing time,shoulder joint extension range of motion,disabilities of arm,shoulder and hand (DASH) questionnaire score,Neer score or ConstantMurley score and complications were compared between two groups.
Results A total of 7 literatures were included,1 was prospective study,6 were retrospective cohort study. There were 521 children,264 children in Kirschner wire group and 257 children in elastic intramedullary nail fixation group. The results of Meta-analysis showed operation time[WMD=-12.61,95%CI (-24.89,-0.33),P=0.04],fracture healing time[WMD=-0.26,95%CI(-0.49,-0.02),P=0.03],total complication rate[OR=6.83,95%CI (3.33,14.01),P<0.001],nail tract infection rate[OR=6.77,95%CI (1.72,26.69),P=0.006] and displacement fracture rate[OR=3.57,95%CI (1.35,9.44),P=0.01] between two groups had statistically differences (P>0.05),while there were no statistically significant difference in comparison of hospital stay,shoulder joint extension range of motion,DASH,Neer score,Constant-Murley score,and incidence of skin irritation between two groups (P>0.05).
Conclusion Kirschner's needle internal fixation has a short operation time and simple operation,but it has a higher incidence of complications compared with elastic nail internal fixation technique. In terms of efficacy and safety,elastic intramedullary nail fixation is one of the options for the treatment of proximal humeral fractures in children. |
| KEYWORDS:Proximal humerus fracture Kirschner's needle Elastic stable intramedullary nail Complication 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: | 施涛,徐子航,张鑫,钱宇望,朱磊,孔来法.克氏针与弹性髓内钉固定治疗儿童肱骨近端骨折Meta分析[J].中国骨伤,2025,38(6):633~640 |
| 英文格式: | SHI Tao,XU Zi-hang,ZHANG Xin,QIAN Yu-wang,ZHU Lei,KONG Lai-fa.Meta analysis of Kirschner's needle and elastic intramedullary nail fixation for the treatment of proximal humeral fractures in children[J].zhongguo gu shang / China J Orthop Trauma ,2025,38(6):633~640 |
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