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[1]盧承印,石淇允,張來福,等.掌側(cè)入路與背側(cè)入路加壓螺釘固定治療腕舟骨骨折療效和安全性的Meta分析[J].中醫(yī)正骨,2021,33(06):42-48.
　LU Chengyin,SHI Qiyun,ZHANG Laifu,et al.Clinical efficacy and safety of compression screw fixation through volar approach versus dorsal approach for treatment of scaphoid fractures:a meta analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(06):42-48.
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掌側(cè)入路與背側(cè)入路加壓螺釘固定治療腕舟骨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33卷
期數(shù):
2021年06期
頁碼:
42-48
欄目:
文獻(xiàn)研究
出版日期:
2021-06-20

文章信息/Info

Title:
Clinical efficacy and safety of compression screw fixation through volar approach versus dorsal approach for treatment of scaphoid fractures:a meta analysis
作者:
盧承印1; 石淇允2; 張來福1; 王孝輝3
1.河南中醫(yī)藥大學(xué),河南 鄭州 450046; 2.湖南中醫(yī)藥大學(xué),湖南 長沙 410208; 3.河南省洛陽正骨醫(yī)院/河南省骨科醫(yī)院,河南 洛陽 471002
Author(s):
LU Chengyin1; SHI Qiyun2; ZHANG Laifu1; WANG Xiaohui3
1.Henan University of Chinese Medicine,Zhengzhou 450046,Henan,China 2.Hunan University of Chinese Medicine,Changsha 410208,Hunan,China 3.Luoyang Orthopedic-Traumatological Hospital,Luoyang 471002,Henan,China
關(guān)鍵詞:
舟骨;  腕損傷;  骨折;  手術(shù)入路;  Meta分析
Keywords:
scaphoid bone;  wrist injuries;  fractures; bone;  operative approach;  meta-analysis
摘要:
目的:比較掌側(cè)入路與背側(cè)入路加壓螺釘固定治療腕舟骨骨折的療效與安全性。方法:應(yīng)用計(jì)算機(jī)檢索PubMed、Embase、The Cochrane Library、中國知網(wǎng)、維普網(wǎng)、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫和萬方數(shù)據(jù)庫中關(guān)于掌側(cè)入路與背側(cè)入路加壓螺釘固定治療腕舟骨骨折對比研究的文獻(xiàn),檢索時(shí)限為建庫至2020年10月。依據(jù)文獻(xiàn)檢索及篩選方案篩選出符合要求的文獻(xiàn)后,由2名研究人員分別獨(dú)立進(jìn)行數(shù)據(jù)提取和質(zhì)量評價(jià)。采用RevMan5.3軟件進(jìn)行Meta分析。結(jié)果:共檢索到316篇文獻(xiàn),最終納入17篇文獻(xiàn),共涉及872例患者。Meta分析結(jié)果顯示,掌側(cè)入路組和背側(cè)入路組手術(shù)時(shí)間和腕關(guān)節(jié)掌屈、背伸、橈偏、尺偏活動(dòng)度及Mayo腕關(guān)節(jié)評分的組間差異均無統(tǒng)計(jì)學(xué)意義[I2=60%,MD=2.37,95%CI(-0.13,4.88),P=0.060; I2=40%,SMD=0.10,95%CI(-0.15,0.34),P=0.440; I2=18%,SMD=-0.02,95%CI(-0.26,0.23),P=0.880; I2=48%,SMD=-0.06,95%CI(-0.31,0.18),P=0.610; I2=26%,SMD=0.17,95%CI(-0.08,0.41),P=0.180; I2=0%,MD=-0.15,95%CI(-1.44,1.13),P=0.820]; 掌側(cè)入路組術(shù)中出血量少于背側(cè)入路組[I2=95%,MD=-4.63,95%CI(-8.64,-0.62),P=0.020],骨折愈合時(shí)間短于背側(cè)入路組[I2=92%,MD=-2.42,95%CI(-4.19,-0.65),P=0.007],綜合療效優(yōu)良率高于背側(cè)入路組[I2=0%,OR=2.64,95%CI(1.50,4.67),P=0.001],骨折不愈合率及其他并發(fā)癥發(fā)生率均低于背側(cè)入路組[I2=18%,OR=0.41,95%CI(0.19,0.91),P=0.030; I2=0%,OR=0.48,95%CI(0.28,0.82),P=0.007]。結(jié)論:現(xiàn)有的證據(jù)表明,掌側(cè)入路與背側(cè)入路加壓螺釘固定治療腕舟骨骨折,在手術(shù)時(shí)間、腕關(guān)節(jié)功能恢復(fù)方面無明顯差異,但掌側(cè)入路加壓螺釘固定比背側(cè)入路加壓螺釘固定術(shù)中出血少、骨折愈合快、綜合療效好、并發(fā)癥發(fā)生率低。
Abstract:
Objective:To compare the clinical efficacy and safety of compression screw fixation through volar approach(VA)versus dorsal approach(DA)in treatment of scaphoid fractures.Methods:All the randomized controlled trial(RCT)and non-RCT articles about compression screw fixation through VA(VA group)versus DA(DA group)for treatment of scaphoid fractures included from database establishing to October 2020 were retrieved from PubMed,Embase,The Cochrane Library,China National Knowledge Internet,Vip Database,Chinese Biomedical Literature Database and WanFang Database 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 a Meta-analysis was conducted by using RevMan5.3 software.Results:Three hundred and sixteen articles were searched out.After screening,17 articles(872 patients)were included in the final analysis.The results of Meta-analysis revealed that there was no statistical difference in operative time,range of motion of wrist(palmar flexion,dorsal expansion,radial deviation and ulnar deviation)and Mayo wrist scores between VA group and DA group(I2=60%,MD=2.37,95%CI(-0.13,4.88),P=0.060; I2=40%,SMD=0.10,95%CI(-0.15,0.34),P=0.440; I2=18%,SMD=-0.02,95%CI(-0.26,0.23),P=0.880; I2=48%,SMD=-0.06,95%CI(-0.31,0.18),P=0.610; I2=26%,SMD=0.17,95%CI(-0.08,0.41),P=0.180; I2=0%,MD=-0.15,95%CI(-1.44,1.13),P=0.820).The intraoperative blood loss was less,fracture healing time was shorter,excellent rate of comprehensive curative effect was higher,and fracture nonunion rate as well as other complication incidence were lower in VA group compared to DA group(I2=95%,MD=-4.63,95%CI(-8.64,-0.62),P=0.020; I2=92%,MD=-2.42,95%CI(-4.19,-0.65),P=0.007; I2=0%,OR=2.64,95%CI(1.50,4.67),P=0.001; I2=18%,OR=0.41,95%CI(0.19,0.91),P=0.030; I2=0%,OR=0.48,95%CI(0.28,0.82),P=0.007).Conclusion:Available evidences suggest that there is no obvious difference in operative time and wrist function recovery between VA and DA in compression screw fixation for treatment of scaphoid fractures,however,the former has such advantages as less intraoperative blood loss,faster fracture healing,better comprehensive curative effects and lower complication incidence compared to the latter.

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備注/Memo

備注/Memo:
通訊作者:王孝輝 E-mail:[email protected]
更新日期/Last Update: 2021-12-20