髓内固定与髓外钉板固定治疗成人股骨转子下骨折的Meta分析A Meta- analysis of intramedullary nailing versus extramedullary plate fixation for subtrochanteric fractures in adults
袁春晓;阿里木江·阿不来提;李京;王国旗;杨新明;艾合买提江·玉素甫;
摘要(Abstract):
[目的]对髓内固定与髓外钉板固定治疗成人股骨转子下骨折的疗效及安全性进行评价。[方法]按照Cochrane图书馆提供的系统评价方法,计算机检索PubMed(1980~2013年10月)、Cochrane图书馆(2013年第10期)、Embase(1980~2013年10月)以及CNKI、CBM等中外生物医学数据库,收集关于髓内固定与髓外钉板固定比较治疗成人股骨转子下骨折的文献。对文献进行方法学质量评价。采用Cochrane协作网提供的RevMan 5.2.5进行Meta分析,以比较髓内固定与髓外钉板固定术后疗效及安全性相关指标有无差异。[结果]共纳入5个研究,其中4篇RCTs,1篇非随机临床对照研究。共计241例,其中140例行髓内钉固定,101例行髓外钉板固定。Meta分析结果显示:与髓外钉板固定相比,髓内钉固定组可降低术后内固定失败率[RR=0.25,95%CI(0.10,0.67),P=0.005]和骨折不愈合率[RR=0.17,95%CI(0.04,0.74),P=0.02],并且可提高早期下床活动率,两者在感染发生率、股骨骨折发生率及手术时间、住院天数上差异无明显统计学意义。[结论]髓内钉固定治疗股骨转子下骨折能降低内固定失败率及骨不愈合率,可早期下床活动。
关键词(KeyWords): 股骨转子下骨折;髓内钉;髓外钢板;Meta分析
基金项目(Foundation):
作者(Author): 袁春晓;阿里木江·阿不来提;李京;王国旗;杨新明;艾合买提江·玉素甫;
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DOI:
参考文献(References):
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