摘要
[目的]对桥接外固定与非桥接外固定治疗不稳定桡骨远端骨折的疗效及并发症进行Meta分析。[方法]计算机检索1978～2013年Medline、Embase、Cochrane图书馆、PubMed、中国生物医学文献数据库;收集桥接与非桥接外固定比较治疗不稳定桡骨远端骨折的文献。用RevMan 5.1软件进行Meta分析,以比较两种外固定治疗不稳定桡骨远端骨折术后腕关节活动度、握力、影像学指标及并发症方面有无差异。[结果]共纳入5篇文献,包括RCT(Randomized Controlled Trial)4篇,病例对照研究1篇,共计821例患者,桥接外固定347例,非桥接外固定474例。Meta分析结果示:非桥接固定组术后屈曲、旋后功能、握力及掌倾角恢复情况优于桥接外固定组,钉道感染率、拇长伸肌腱断裂发生率非桥接固定组高于桥接固定组,而桥接外固定组伸直功能优于非桥接外固定组,以上差异均有统计学意义。桡倾角及尺骨偏移恢复情况两组无明显差异。[结论]非桥接外固定术后腕关节功能恢复良好,可作为临床桡骨远端不稳定骨折首选治疗方案。
[ Objective] To systematically compare the operative effect and complications of unstable fractures of distal radi- us treated by wrist-bridging and no-bridging external fixations. [ Method ] The database of Medline, Embase, Cochrane library, CBM databases（ from 1978 to 2013 ） were researched for articles which compared wrist-bridging and non-bridging external fixa- tions for the unstable fractures of the distal radius. The RevMan 5.1 were used to perform Meta-analysis to compare the range of the wrist motion, grip strength ,radiographic index ,the postoperative complications after different external fixation. [ Result] Five studies（4 RCTs and 1 comparative study） were brought into this research that included 821 patients. There were 347 patients who were treated by Wrist-bridging external fixation, and 474 patients by non-bridging. The Meta-snalysis showed that the fuction （flexition and supination） ,radiographic index（ palmar tilt） of the wrist and the grip strength in non-bridging group were signifi- cantly better than in wrist bridging group. Compared with wrist bridging group,non-bridging group significantly increased the risk of infection of the pin site, rupture of the extensor pollicis. The extension of the wrist-bridging group was better than the non- bridging one. There were no statistical difference regarding the radial inclination and the ulnar variance. [ Conclusion] Compared with wrist-bridging external fixation for the unstable fractures of the distal radius, non-bridging has better wrist joint function, and can be used as clinical treatment of unstable distal radius fracture.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2013年第24期2475-2480,共6页
Orthopedic Journal of China
关键词
桡骨骨折
外固定
META分析
radius fractures, external fixation, Meta-analysis
