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《International journal of oral and maxillofacial surgery》2020,49(7):914-931
Titanium osteosynthesis is currently the fixation system of choice in maxillofacial traumatology. Biodegradable osteosynthesis systems have the ability to degrade in the human body. The aim of this study was to conduct a systematic review, with meta- and trial sequential analyses, to assess the efficacy and morbidity of biodegradable versus titanium osteosynthesis after maxillofacial trauma. MEDLINE, Embase, and CENTRAL were searched for randomized controlled trials and prospective and retrospective controlled studies. Five time periods were studied: perioperative, short-term (0–4 weeks), intermediate (6–12 weeks), long-term (>12 weeks), and overall follow-up. After screening 3542 records, 24 were included. All had a high risk of performance and detection bias due to the nature of the interventions. Meta-analysis showed no differences in efficacy or morbidity between biodegradable and titanium osteosynthesis. The risk of perioperative screw breakage was significantly higher (risk ratio 17.13, 95% confidence interval 2.19–34.18) and the symptomatic plate removal rate lower in the biodegradable group (risk ratio 0.11, 95% confidence interval 0.02–0.57), which was confirmed by the trial sequential analysis. The quality of evidence ranged from very low to moderate. Based on the narrative review and meta-analyses, current evidence shows that biodegradable osteosynthesis is a viable alternative to titanium osteosynthesis when applied in the treatment of maxillofacial trauma, with similar efficacy but significantly lower symptomatic plate removal rates. Perioperative screw breakage occurred significantly more often in the biodegradable group compared to the titanium group. 相似文献
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F. Lesoin M. Rousseaux N. Bouasakao L. Villette C. E. Thomas A. Cama M. Jomin 《Acta neurochirurgica》1986,81(3-4):118-124
Summary The authors report 165 cases of thoraco-lumbar lesions with neurological dysfunction. All the patient were operated. They analyze the neurological and mechanical results and indicate the use of different osteosynthesis apparatus according to the type and level of lesions.Harrington's rods seem to give more precise repositioning while Roy Camille's plates give more stability. When the posterior wall of the spinal canal is intact, Kempf's compression rods can be used.Thoraxic spine injuries seem to be an indication for Harrington's rods, while lumbar injuries seem to call for Camille's plates. 相似文献
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A simulation study of three sequential methods for the comparison of two treatment groups when the response criterion is censored 总被引:1,自引:0,他引:1
Three recent sequential methods, group sequential analysis (GSA), the sequential probability ratio test (SPRT) and the triangular test (TT) are well suited to randomized clinical trials with a censored response criterion, as they do not require matched pairs of patients. We undertook a simulation study to investigate their statistical properties and to compare these three methods with the fixed-sample design. Our results suggest that the three methods have the expected statistical properties for size and power; they allow an important reduction of the average number of events before stopping, except with GSA when there is no treatment difference; the triangular test (closed design) appears the optimal design, as the variance of the number of events is smaller than with the sequential probability ratio test (open design) and analysis after every twenty new events does not alter the statistical properties of these sequential methods and enhances their usefulness. 相似文献
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目的探讨应用桥接钢板治疗长管状骨高能量损伤的临床疗效。方法应用桥接钢板的形式治疗长管状骨的高能量损伤37例。其中股骨粉碎性骨折12例,胫腓骨粉碎性骨折17例,肱骨粉碎性骨折3例,尺桡骨粉碎性骨折5例。结果全部病例得到随访,时间45d~2年,1年内骨性愈合34例,延迟愈合3例,无骨不连病例。根据自定的长管状骨愈合评价标准,本组优21例,良13例,中3例。结论长管状骨的高能量损伤骨折形式复杂,治疗较棘手,应用桥接钢板的形式进行治疗可最大限度地保留骨折部的血运,有利于骨折的按期愈合及减少并发症。 相似文献
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微创经皮钢板骨桥接术联合锁定加压钛板治疗胫骨远端骨折 总被引:4,自引:0,他引:4
目的探讨微创经皮钢板骨桥接术(minimallyi nvasive percutaneous plate osteosynthesis,MIPPO)联合锁定加压钛板(locking compression plate,LCP)治疗胫骨远端骨折的近期疗效。方法2004年6月~2006年3月采用MIPPO联合LCP治疗胫骨远端骨折16例,AO分型:43A1型7例,43A3型5例,43B1型2例,43C3型2例。采用3种方法复位胫骨骨折后插入LCP,用锁定螺钉固定。结果16例随访5~20个月,平均11,5月。16例切口一期愈合,骨折无延迟愈合、畸形愈合、断钉、断板等并发症。术后X线检查4~12周(平均7.6周)骨痂形成并开始部分负重,8~20周骨性愈合(平均16周),此时开始完全负重。3例出现胫骨远端内植物局部不适。根据美国足踝骨科学会评分系统对踝关节功能评分,优14例(87.5%),良2例(12,5%)。结论MIPPO具有创伤小、固定牢靠、可早期功能锻炼等优点,近期疗效满意,是治疗胫骨远端骨折的有效方法。 相似文献
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