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[1]滕浩,楊勝真,孫然,等.髓內釘內固定與鎖定鋼板內固定治療老年肱骨近端骨折療效和安全性的Meta分析[J].中醫(yī)正骨,2023,35(05):25-31.
　TENG Hao,YANG Shengzhen,SUN Ran,et al.Clinical efficacy and safety of internal fixation with intramedullary nail versus locking plate for treatment of proximal humeral fractures in the aged:a meta analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(05):25-31.
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髓內釘內固定與鎖定鋼板內固定治療老年肱骨近端骨折療效和安全性的Meta分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期數(shù):
2023年05期
頁碼:
25-31
欄目:
文獻研究
出版日期:
2023-05-20

文章信息/Info

Title:
Clinical efficacy and safety of internal fixation with intramedullary nail versus locking plate for treatment of proximal humeral fractures in the aged:a meta analysis
作者:
滕浩1; 楊勝真1; 孫然1; 王巖1; 王福棟1; 孟凱2
(1.山東中醫(yī)藥大學第一臨床醫(yī)學院,山東 濟南 250014; 2.山東中醫(yī)藥大學附屬醫(yī)院,山東 濟南 250014)
Author(s):
TENG Hao1; YANG Shengzhen1; SUN Ran1; WANG Yan1; WANG Fudong1; MENG Kai2
1.The First Clinical Medical College of Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong,China 2.The Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong,China
關鍵詞:
肩骨折;  肱骨骨折;  骨折固定術; 內;  骨釘;  骨板;  老年人;  專題Meta分析
Keywords:
shoulder fractures;  humeral fractures;  fracture fixation; internal;  bone nails;  bone plates;  aged;  meta-analysis as topic
摘要:
目的:比較髓內釘內固定與鎖定鋼板內固定治療老年肱骨近端骨折的療效和安全性。方法:應用計算機檢索中國知網、維普網、萬方數(shù)據(jù)庫、PubMed、Embase、Web of Science和Cochrane Library中關于髓內釘內固定與鎖定鋼板內固定治療老年肱骨近端骨折的對比研究文獻,檢索時限均為建庫至2022年4月。試驗組采用髓內釘內固定治療,對照組采用鎖定鋼板內固定治療。依據(jù)文獻檢索及篩選方案篩選出符合要求的文獻后,由2名研究人員分別獨立進行數(shù)據(jù)提取和質量評價。采用Revman5.4軟件進行Meta分析。結果:共檢索到409篇文獻,最終納入8篇文獻,共涉及566例患者。Meta分析結果顯示,試驗組手術時間、骨折愈合時間短于對照組[MD=-21.28,95%CI(-31.97,-10.59),P=0.000; MD=-0.54,95%CI(-0.77,-0.31),P=0.000],術中出血量少于對照組[MD=-93.06,95%CI(-146.47,-39.66),P=0.001],術后切口疼痛視覺模擬量表評分低于對照組[MD=-0.28,95%CI(-0.54,-0.02),P=0.030],骨折愈合后肱骨頸干角大于對照組[MD=3.81,95%CI(2.11,5.50),P=0.000]; 2組肩關節(jié)前屈活動度、肩關節(jié)外旋活動度、Constant-Murley肩關節(jié)評分、美國肩肘關節(jié)外科醫(yī)師協(xié)會評分及并發(fā)癥發(fā)生率比較,組間差異均無統(tǒng)計學意義[MD=0.04,95%CI(-3.11,3.18),P=0.980; MD=0.40,95%CI(-3.02,3.81),P=0.820; MD=0.89,95%CI(-0.96,2.73),P=0.350; MD=0.93,95%CI(-0.89,2.75),P=0.320; OR=0.66,95%CI(0.42,1.05),P=0.080]。結論:髓內釘內固定治療老年肱骨近端骨折在恢復肩關節(jié)功能和安全性方面與鎖定鋼板內固定相當,但前者在縮短手術時間、減少術中出血量、緩解術后切口疼痛、促進骨折愈合、糾正肱骨頸干角等方面更具優(yōu)勢。
Abstract:
Objective:To compare the clinical efficacy and safety of internal fixation with intramedullary nail(IMN)versus locking plate(LP)in treatment of proximal humeral fractures in the aged.Methods:All the randomized controlled trial(RCT)and non-RCT articles about clinical efficacy and safety of internal fixation with IMN(experiment group)versus LP(control group)for treatment of proximal humeral fractures in the aged included from database establishing to April 2022 were retrieved from China National Knowledge Internet,Vip Database,Wanfang Database,PubMed,Embase,Web of Science and Cochrane Library through computer.The articles were screened and the information was extracted independently by two researchers according to the retrieval and screening scheme.The methodological quality of research in the articles was evaluated independently by the same two researchers,and if any disagreement was found between them,discussion was conducted or another researcher was invited for making a final decision,and then a Meta-analysis was conducted by using Revman5.4 software.Results:Four hundred and nine articles were searched out.After screening,8 articles(566 patients)were included in the final analysis.The results of Meta-analysis revealed that the operative time and fracture healing time were shorter,the intraoperative blood loss was less,the postoperative incision pain visual analogue scale(VAS)score was lower and the humeral neck-shaft angle after fracture healing was greater in experiment group compared to control group(MD=-21.28,95%CI(-31.97,-10.59),P=0.000; MD=-0.54,95%CI(-0.77,-0.31),P=0.000; MD=-93.06,95%CI(-146.47,-39.66),P=0.001; MD=-0.28,95%CI(-0.54,-0.02),P=0.030; MD=3.81,95%CI(2.11,5.50),P=0.000).There was no statistical difference in range of motion of shoulder anteflexion and extorsion,Constant-Murley shoulder score,American shoulder and elbow surgeons(ASES)score and complication incidence between the 2 groups(MD=0.04,95%CI(-3.11,3.18),P=0.980; MD=0.40,95%CI(-3.02,3.81),P=0.820; MD=0.89,95%CI(-0.96,2.73),P=0.350; MD=0.93,95%CI(-0.89,2.75),P=0.320; OR=0.66,95%CI(0.42,1.05),P=0.080).Conclusion:Internal fixation with IMN is similar to internal fixation with LP in shoulder function recovery and safety in treatment of proximal humeral fractures in the aged,while the former displays more advantages in shortening operative time,reducing intraoperative blood loss,relieving postoperative incision pain,promoting fracture healing and correcting humeral neck-shaft angle compared to the latter.

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備注/Memo

備注/Memo:
通訊作者:孟凱 E-mail:[email protected]
更新日期/Last Update: 1900-01-01