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[1]肖輝,李京.切開(kāi)復(fù)位接骨板內(nèi)固定與非手術(shù)治療成人鎖骨中段骨折的療效及安全性系統(tǒng)評(píng)價(jià)[J].中醫(yī)正骨,2017,29(07):37-40,45.
　XIAO Hui,LI Jing.Systematic review on the curative effect and safety of open reduction and interal fixation with bone plate versus nonoperative treatment for treatment of middle clavicular fractures in adults[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(07):37-40,45.
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切開(kāi)復(fù)位接骨板內(nèi)固定與非手術(shù)治療成人鎖骨中段骨折的療效及安全性系統(tǒng)評(píng)價(jià)()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期數(shù):
2017年07期
頁(yè)碼:
37-40,45
欄目:
文獻(xiàn)研究
出版日期:
2017-07-20

文章信息/Info

Title:
Systematic review on the curative effect and safety of open reduction and interal fixation with bone plate versus nonoperative treatment for treatment of middle clavicular fractures in adults
作者:
肖輝; 李京
河南省新鄉(xiāng)市第一人民醫(yī)院,河南 新鄉(xiāng) 453000
Author(s):
XIAO Hui; LI Jing
The Xinxiang First People's Hospital,Xinxiang 453000,Henan,China
關(guān)鍵詞:
Meta分析;  系統(tǒng)評(píng)價(jià);  鎖骨骨折;  成年人;  骨折固定術(shù); 內(nèi);  骨板;  非手術(shù)治療
Keywords:
Key words Meta-Analysis;  systematic review;  clavicle fracture;  adult;  fracture fixation; internal;  bone plates;  nonoperative treatment
摘要:
目的:系統(tǒng)評(píng)價(jià)和對(duì)比切開(kāi)復(fù)位接骨板內(nèi)固定與非手術(shù)治療成人鎖骨中段骨折的療效及安全性。方法:通過(guò)計(jì)算機(jī)檢索The Cochrane Library(2016年第5期)、PubMed、Embase、High Wire Press、Springer Link、CNKI、CBM、WanFang Data建庫(kù)至2016年5月國(guó)內(nèi)外公開(kāi)發(fā)表的所有切開(kāi)復(fù)位接骨板內(nèi)固定(接骨板固定組)與非手術(shù)(非手術(shù)組)治療成人鎖骨中段骨折的隨機(jī)對(duì)照試驗(yàn)文獻(xiàn),同時(shí)手工檢索本專業(yè)相關(guān)期刊從1990年1月至2016年5月的所有相關(guān)文獻(xiàn)。由2位評(píng)價(jià)員獨(dú)立對(duì)檢索到的文獻(xiàn)進(jìn)行篩選與質(zhì)量評(píng)價(jià),采用Cochrane協(xié)作網(wǎng)提供的Revman5.2.5軟件進(jìn)行Meta分析。結(jié)果:共檢出文獻(xiàn)516篇,經(jīng)逐層篩選最終納入4篇英文文獻(xiàn),均為隨機(jī)對(duì)照試驗(yàn)文獻(xiàn),共涉及390例患者,其中接骨板固定組200例、非手術(shù)組190例。Meta分析結(jié)果顯示,治療后接骨板固定組的Constant評(píng)分和DASH評(píng)分均優(yōu)于非手術(shù)組[WMD=3.26,95%CI(0.45,6.06); WMD=-2.72, 95%CI(-4.99,-0.44)],非手術(shù)組骨折不愈合率和骨折畸形愈合率均高于接骨板固定組[RR=0.14,95%CI(0.05,0.37); RR=0.15,95%CI(0.06,0.33)]。結(jié)論:與非手術(shù)治療相比,采用切開(kāi)復(fù)位接骨板內(nèi)固定治療成人鎖骨中段骨折,患者上肢及肩關(guān)節(jié)功能恢復(fù)更好,骨折不愈合和畸形愈合的發(fā)生率更低。
Abstract:
ABSTRACT Objective:To systematically evaluate and compare the curative effect and safety of open reduction and interal fixation with bone plate versus nonoperative treatment for treatment of middle clavicular fractures in adults.Methods:All the randomized controlled trial(RCT)articles about open reduction and interal fixation with bone plate(bone plate fixation group)versus nonoperative treatment(nonoperative group)for treatment of middle clavicular fractures in adults that published at home and abroad included from database establishing to May 2016 were retrieved from the Cochrane Library(2016,No.5),PubMed,Embase,High Wire Press,Springer Link,China national knowledge internet,CBM and WanFang Data through computer.Meanwhile,all the relevant articles published in relevant orthopedic journals included from January 1990 to May 2016 were manual retrieved.The acquired articles were screened and the quality of research in the articles was evaluated independently by two assessors.A Meta-analysis was conducted by using Revman 5.2.5 software provided by Cochrane Collaboration.Results:Five hundred and sixteen articles were searched out.After screening,4 English articles(RCT)were included in the final analysis,200 patients in bone plate fixation group and 190 patients in nonoperative group.The result of Meta-analysis demonstrated that bone plate fixation group surpassed nonoperative group in Constant scores and DASH scores after the treatment[WMD=3.26,95%CI(0.45,6.06); WMD=-2.72, 95%CI(-4.99,-0.44)] and the fracture nonunion rate and fracture malunion rate were higher in nonoperative group compared to bone plate fixation group(RR=0.14,95%CI(0.05,0.37); RR=0.15,95%CI(0.06,0.33)).Conclusion:Better functional recovery of upper limbs and shoulder joints and lower incidence rates of fracture nonunion and fracture malunion can be obtained by open reduction and interal fixation with bone plate compared to nonoperative therapy in the treatment of middle clavicular fractures in adults.

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備注/Memo

備注/Memo:
通訊作者:肖輝 E-mail:[email protected]
更新日期/Last Update: 2017-12-29