杨召;马信龙;马剑雄;苑珍珍;孙晓雷;邢丹;

• 1:天津市天津医院骨科
• 2:天津医科大学总医院骨科

摘要(Abstract)：

[目的]系统评价动态外固定架与静态外固定架两种方法治疗不稳定桡骨远端骨折的远期疗效。[方法]计算机检索PubMed,EMBASE,BIOSIS,Springer和Cochrane Library等数据库,纳入关于动态外固定架与静态外固定架两种方法治疗不稳定桡骨远端骨折远期疗效比较的随机对照试验(RCT)。制定入选和剔除标准,筛选出符合纳入标准的文献,评价纳入研究的方法学质量。利用RevMan 5.0(Cochrane Library)进行Meta分析。[结果]共有4篇研究符合纳入标准,共238例患者,动态外固定架组119例,静态外固定架组119例。Meta分析结果显示:动态外固定架与静态外固定架比较,在术后并发症(针道感染及反射性交感神经营养不良)和术后1年患肢临床疗效(旋前、旋后、伸展、屈曲、桡偏及尺偏)方面,两者差异均无统计学意义(P>0.05);而术后1年桡骨长度恢复方面,前者优于后者(P<0.05)。[结论]动态外固定架与静态外固定架治疗不稳定桡骨远端骨折都取得了良好的远期疗效;在术后并发症和术后1年患肢临床疗效方面,两者疗效并无显著差异;但在术后桡骨长度恢复方面,动态外固定架优于静态外固定架。

关键词(KeyWords)： 桡骨远端骨折;动态外固定架;静态外固定架;疗效;Meta分析

Abstract:

Keywords:

基金项目(Foundation): 天津市科技支撑重点项目(编号:13ZCZDSY01700;11ZCGYSY01800);; 天津市卫生局科技攻关项目(编号:11KG137);; 天津市中医药管理局重点课题(编号:13123)

作者(Author): 杨召;马信龙;马剑雄;苑珍珍;孙晓雷;邢丹;

Email:

DOI:

参考文献(References)：

• [1]Sando IC,Malay S,KC Chung.Analysis of publication bias in the literature for distal radius fracture[J].J Hand Surg Am,2013,38:927-934.
• [2]Siripakarn Y,Suntarapa T,Chernchujit B.Multipurpose external fixation for unstable comminuted intraarticular fracture of distal radius[J].J Med Assoc Thai,2013,96:446-455.
• [3]Mostafa M F.Treatment of distal radial fractures with antegrade intra-medullary Kirschner wires[J].Strat Trauma Limb Reconstr,2013,2:89-95.
• [4]Kuo LC,Yang TH,Hsu YY,et al.Is progressive early digit mobilization intervention beneficial for patients with external fixation of distal radius fracture?A pilot randomized controlled trial[J].Clin Rehabil,2013,27:983-993.
• [5]Kulshrestha V,Roy T,Audige L.Dynamic vs static external fixation of distal radial fractures:a randomized study[J].Indian J Orthop,2011,45:527-534.
• [6]Hove LM,Krukhaug Y,Revheim K,et al.Dynamic compared with static external fixation of unstable fractures of the distal part of the radius:a prospective,randomized multicenter study[J].J Bone Joint Surg Am,2010,92:1687-1696.
• [7]Cui,Z,Yu B,Hu Y,et al.Dynamic versus static external fixation for unstable distal radius fractures:an up-to-date meta-analysis[J].Injury,2012,43:1006-1013.
• [8]Oremus M,Wolfson C,Perrault A,et al.Interrater reliability of the modified Jadad quality scale for systematic reviews of Alzheimer's disease drug trials[J].Dement Geriatr Cogn Disord,2001,12:232-236.
• [9]Modi CS,Ho K,Smith CD,et al.Dynamic and static external fixation for distal radius fractures-a systematic review[J].Injury,2010,41:1006-1011.
• [10]Handoll HH,Huntley JS,Madhok R.Different methods of external fixation for treating distal radial fractures in adults[J].Cochrane Database Syst Rev,2008,23:CD006522.
• [11]Lourie GM,Lins RE.Static external fixation in the hand and carpus[J].Hand Clin,1997,13:627-642.
• [12]Hertel R,Jakob RP.Static external fixation of the wrist[J].Hand Clin,1993,9:567-575.
• [13]McQueen MM,Hajducka C,Court-Brown CM.Redisplaced unstable fractures of the distal radius:a prospective randomised comparison of four methods of treatment[J].J Bone Joint Surg Br,1996,78:404-409.
• [14]Sommerkamp TG,Seeman M,Silliman J,et al.Dynamic external fixation of unstable fractures of the distal part of the radius.A prospective,randomized comparison with static external fixation[J].J Bone Joint Surg Am,1994,76:1149-1161.
• [15]Colles A.On the fracture of the carpal extremity of the radius[J].Edinb Med Surg J,1814,10:181.
• [16]Leung F,Tu YK,Chew WY,et al.Comparison of external and percutaneous pin fixation with plate fixation for intra-articular distal radial fractures.A randomized study[J].J Bone Joint Surg Am,2008,90:16-22.
• [17]Slutsky DJ.External fixation of distal radius fractures[J].J Hand Surg Am,2007,32:1624-1637.
• [18]Clyburn TA.Dynamic external fixation for comminuted intra-articular fractures of the distal end of the radius[J].J Bone Joint Surg Am,1987,69:248-254.
• [19]Salter RB,Simmonds DF,Malcolm BW,et al.The biological effect of continuous passive motion on the healing of full-thickness defects in articular cartilage.An experimental investigation in the rabbit[J].J Bone Joint Surg Am,1980,62:1232-1251.
• [20]Lidstrom A.Fractures of the distal end of the radius.a clinical and statistical study of end results[J].Acta Orthop Scand Suppl,1959,41:1-118.