合并尺骨茎突骨折对桡骨远端骨折患者桡尺远侧关节功能影响的Meta分析

目的:评价合并尺骨茎突骨折对桡骨远端骨折患者桡尺远侧关节功能的影响。方法:计算机检索PubMed、Embase、Cochrance library、中国知网、万方数据库中所有对比合并或不合并尺骨茎突骨折的桡骨远端骨折患者桡尺远侧关节功能的随机对照或非随机对照临床试验文献,治疗方法为切开复位掌侧钢板螺钉内固定或跨关节的外固定架固定。检索时限为建库至2019年8月31日。筛选文献、提取数据并评价纳入研究的偏倚风险后,采用Revman5.3软件进行Meta分析。结果:共纳入5篇文献。Meta分析结果显示,合并和不合并尺骨茎突骨折患者(尺骨茎突骨折组和无尺骨茎突骨折组)的腕关节屈曲活动度、背伸活动度比较,组间差异均无统计学意义[屈曲活动度:P=0.850,I^2=0%;WMD=-0.05,95%CI(-1.99,1.88),P=0.960。背伸活动度:P=0.990,I^2=0%;WMD=-0.67,95%CI(-1.35,2.68),P=0.520];2组患者前臂旋前活动度、前臂旋后活动度比较,组间差异均无统计学意义[前臂旋前活动度:P=0.090,I^2=51%;WMD=-1.56;95%CI(-4.64,1.53),P=0.320。前臂旋后活动度:P=0.620,I^2=0%;WMD=-0.39,95%CI(-2.19,1.40),P=0.670];2组患者的上肢功能障碍评分比较,差异无统计学意义[P=0.270,I^2=19%;WMD=3.72,95%CI(-0.20,7.65),P=0.060]。结论:现有的证据表明,合并尺骨茎突骨折不会对桡骨远端骨折患者桡尺远侧关节功能产生影响。

Effects of ulnar styloid fracture on function of distal radioulnar joint in patient with distal radius fracture:a meta analysis

Objective:To evaluate the effects of ulnar styloid fracture on distal radioulnar joint(DRUJ)function in patient with distal radius fracture.Methods:All articles about randomized controlled trial(RCT)and non-RCT comparing DRUJ function of distal radius fracture patients with ulnar styloid fractures(ulnar styloid fracture group)and DRUJ function of distal radius fracture patients without ulnar styloid fractures(non-ulnar styloid fracture group)that published at home and abroad included from database establishing to August 31,2019 were retrieved from PubMed,Embase,Cochrance library,China national knowledge internet and WanFang Database through computer.The patients were treated with open reduction and volar plate and screw internal fixation or frame external fixation across the wrist.The articles were screened and the information was extracted.The risk of bias of included researches in the articles was assessed and a Meta-analysis was conducted by using Revman5.3 software.Results:Five articles were included in the final analysis.The results of Meta-analysis demonstrated that there was no statistical difference in wrist palmar flexion range of motion(ROM)and wrist dorsiflexion ROM between ulnar styloid fracture group and non-ulnar styloid fracture group(palmar flexion ROM:P=0.850,I^2=0%;WMD=-0.05,95%CI(-1.99,1.88),P=0.960.dorsiflexion ROM:P=0.990,I^2=0%;WMD=-0.67,95%CI(-1.35,2.68),P=0.520).There was no statistical difference in forearm pronation ROM and forearm supination ROM between ulnar styloid fracture group and non-ulnar styloid fracture group(forearm pronation ROM:P=0.090,I^2=51%;WMD=-1.56;95%CI(-4.64,1.53),P=0.320.forearm supination ROM:P=0.620,I 2=0%;WMD=-0.39,95%CI(-2.19,1.40),P=0.670).There was no statistical difference in the disabilities of the arm,shoulder and hand(DASH)scores between ulnar styloid fracture group and non-ulnar styloid fracture group(P=0.270,I^2=19%;WMD=3.72,95%CI(-0.20,7.65),P=0.060).Conclusion:Available evidences suggest that the ulnar styloid fracture has no effects on DRUJ function in patient with distal radius fracture.