空心钉与接骨板内固定治疗肱骨大结节骨折疗效的Meta分析

目的:比较空心钉与接骨板治疗肱骨大结节骨折的临床疗效.方法:计算机检索PubMed、EMbase、Cochrane 图书馆、万方、中国知网、中国生物医学文献数据库、维普中文网等数据库采用空心钉与接骨板治疗肱骨大结节骨折的临床试验文献.检索时间 自2010 年1 月1 日至2020 年1 月1日.根据纳入与排除标准进行独...

Clinical effects between cannulated screw and bone plate internal fixation for humeral tuberosity fracture: a Meta analysis

Objective: To compare clinical effect of cannulated screw and bone plate for the treatment of humeral fracture of greater tuberosity.Methods: From January 2010 to January 2020,clinical trial literatures on the treatment of humeral tuberosity fractures with cannulated screw and bone plate were searched by PubMed,EMbase,Cochrane Library,Wanfang,CNKI,CBM Database,VIP Database and other databases. Independent literature screening,quality evaluation,and data extraction were performed according to inclusion and exclusion criteria. Revman5.2 software was used to perform Meta analysisResults: Totally 5 clinical randomized controlled trials and 12 cohort studies were selected,including 1 068 patients in which 559 patients were treated by cannulated screw internal fixation and 509 patients treated by bone plate internal fixation. Meta analysis resluts showed that there were satistical differences in operation time[MD=-23.03,95% CI(-29.69,-16.36),P<0.000 1],blood loss[MD=-36.39,95% CI(-53.73,-19.04),P<0.000 1],hospital stay[MD=-1.86,95%CI(-3.09,-0.64),P=0.003],fracture healing time[MD=-2.23,95% CI(-4.27,-0.18),P=0.03],postoperative incidence of infection[OR=0.17,95%CI(0.03,0.97),P=0.05],failure rate of internal fixation[OR=3.56,95% CI(1.29,9.81),P=0.01] bwteen two groups. While there were no differences in postoperative visual analogue scale(VAS)[MD=-1.34,95% CI(-2.77,0.09),P=0.07],American Shoulder and Elbow Surgeons(ASES)[MD=0.26,95% CI(-6.43,6.96),P=0.94],Constant shoulder score[MD=-4.05,95% CI(-8.51,0.42),P=0.08],excellent rate of Constant shoulder score[MD=-1.30,95% CI(0.46,3.72),P=0.62],excellent rate of Neer shoulder joint score[OR=2.04,95% CI(0.97,4.28),P=0.06],total complication rate[OR=1.50,95% CI(0.42,5.35),P=0.53],incidence of postoperative pain[OR=0.74,95% CI(0.04,14.49),P=0.84] and incidence of postoperative acromion syndrome[OR=0.88,95% CI(0.02,40.63),P=0.95] between two groups.Conclusion: Compared with bone plate,cannulated screw for the treatment of humeral fracture of greater tuberosity has advantages of shorter opertaion time,less blood loss,shorter hospital stay,lower incidence rate of postopertaive infection,and more benefit for fracture healing.