摘要
[目的]采用荟萃分析评价肱骨近端锁定系统(proximal humeral interlocking system, PHILOS)和锁定肱骨近端钢板(locking proximal humerus plate, LPHP)治疗老年肱骨近端骨折的临床疗效。[方法]检索Pubmed、Embase、中国生物医学文献数据库、中国知网、维普数据库、万方数据库自建库至2024年4月有关国内外文献,采用RevMan5.3软件对纳入文献行荟萃分析。[结果]共纳入11篇文献,均为队列研究。荟萃分析结果显示:PHILOS组手术时间(SMD=-1.32, 95%CI:-2.28~-0.37, P=0.007)、术中出血量(SMD=-1.23, 95%CI:-1.79~-0.67, P<0.001)、骨折愈合时间(SMD=-1.23, 95%CI:-1.79~-0.67, P<0.001)、术后并发症(OR=0.43, 95%CI:0.27~0.68, P<0.001)、术后优良率(OR=4.45, 95%CI:2.47~8.04, P<0.001)、术后肩关节外旋活动度(SMD=1.20, 95%CI:0.32~2.08, P=0.007)、术后肩关节屈曲上举活动度(MD=4.58, 95%CI:2.99~6.17, P<0.001)、术后日常生活能力(MD=1.47, 95%CI:1.06~1.89, P<0.001)、术后肌力(MD=1.18, 95%CI:0.67~1.69, P<0.001)、术后引流量(SMD=-0.57,95%CI:-0.90~-0.24, P<0.001)均显著优于LPHP组,而两组术后CMS、VAS评分的差异无统计学意义(P>0.05)。[结论]本研究表明肱骨近端骨折固定PHILOS临床效果优于LPHP。
[Objective]To compare the clinical consequence of proximal humeral internal locking system(PHILOS)versus locking proximal humerus plate(LPHP)for proximal humerus fractures in the elderly by meta-analysis.[Methods]Relevant literatures at home and abroad were retrieved from Pubmed,Embase,China Biomedical Literature Database,CNKI,VIP Database and Wanfang Database from database establishing to April 2024,and a meta-analysis was performed on the included literatures by RevMan5.3 software.[Results]A total of 11 literatures were included,all of which were cohort studies.As results of the meta-analysis,the PHILOS group proved significantly superior to the LPHP in terms of operative time(SMD=-1.32,95%CI:-2.28~0.37,P=0.007),intraoperative blood loss(SMD=-1.23,95%CI:-1.79~0.67,P<0.001),fracture healing time(SMD=-1.23,95%CI:-1.79~0.67,P<0.001),postoperative complications(OR=0.43,95%CI:0.27~0.68,P<0.001),postoperative excellent and good rate(OR=4.45,95%CI:2.47~8.04,P<0.001),postoperative external rotation ROM of the shoulder(SMD=1.20,95%CI:0.32~2.08,P=0.007),postoperative upward elevation ROM of the shoulder(MD=4.58,95%CI:2.99~6.17,P<0.001),postoperative activity of daily living scale(ALD)(MD=1.47,95%CI:1.06~1.89,P<0.001),postoperative muscle strength(MD=1.18,95%CI:0.67~1.69,P<0.001),and postoperative drainage volume(SMD=-0.57,95%CI:-0.90~-0.24,P<0.001).However,there was no significant difference in CMS and VAS score between the two groups(P>0.05).[Conclusion]This study shows that PHILOS is more effective than LPHP in internal fixation of proximal humerus fractures.
作者
高鑫一
石园林
尚晋
王利兵
乔晓红
GAO Xin-yi;SHI Yuan-lin;SHANG Jin;WANG Li-bing;QIAO Xiao-hong(The Second Department of Orthopaedics,Lüliang Hospital,Shanxi Medical University,Lüliang,Shanxi 033000,China)
出处
《中国矫形外科杂志》
北大核心
2025年第7期615-620,共6页
Orthopedic Journal of China
关键词
老年人
肱骨近端骨折
肱骨近端锁定系统
锁定肱骨近端钢板
荟萃分析
elderly
proximal humerus fractures
proximal humeral internal locking system
locking proximal humerus plate
metaanalysis
