CAJ | 학술논문

背景：桡骨远端不稳定骨折的手术治疗方式主要包括钢板内固定和外固定架，但2种治疗方法各有优缺点，哪种治疗更有利于患者的康复目前仍存在较大争议。 　　目的：通过Meta分析系统评价钢板内固定与外固定架治疗桡骨远端不稳定骨折的临床疗效。 　　方法：计算机和手工检索相关数据库和杂志，收集对比钢板内固定与外固定架治疗桡骨远端不稳定骨折的随机对照试验，提取文献数据及质量评价后，用RevMan5.2软件进行系统评价，比较2组治疗后握力、DASH评分、总的并发症、感染率、畸形愈合率、尺骨变异率等结局指标。 　　结果与结论：纳入9篇文献，患者共524例，内固定组286例，外固定组238例。钢板内固定与外固定支架相比，握力方面2组差异无显著性意义。钢板内固定治疗后3个月及1年DASH评分较优，总的并发症较少，感染率较低，畸形愈合率较低，尺骨变异率较低。说明钢板内固定治疗桡骨远端不稳定骨折疗效优于外固定架，以上结论需要更多大样本、双盲、高质量的随机对照研究加以论证。
배경：뇨골원단불은정골절적수술치료방식주요포괄강판내고정화외고정가，단2충치료방법각유우결점，나충치료경유리우환자적강복목전잉존재교대쟁의。 　　목적：통과Meta분석계통평개강판내고정여외고정가치료뇨골원단불은정골절적림상료효。 　　방법：계산궤화수공검색상관수거고화잡지，수집대비강판내고정여외고정가치료뇨골원단불은정골절적수궤대조시험，제취문헌수거급질량평개후，용RevMan5.2연건진행계통평개，비교2조치료후악력、DASH평분、총적병발증、감염솔、기형유합솔、척골변이솔등결국지표。 　　결과여결론：납입9편문헌，환자공524례，내고정조286례，외고정조238례。강판내고정여외고정지가상비，악력방면2조차이무현저성의의。강판내고정치료후3개월급1년DASH평분교우，총적병발증교소，감염솔교저，기형유합솔교저，척골변이솔교저。설명강판내고정치료뇨골원단불은정골절료효우우외고정가，이상결론수요경다대양본、쌍맹、고질량적수궤대조연구가이론증。
BACKGROUND:The surgical method for the treatment of unstable distal radius fracture mainly includes plate internal fixation and external fixator, but both of these two methods have the advantages and disadvantages. Which treatment is more conducive to the rehabilitation of patients, there is stil controversy. OBJECTIVE:To evaluate the clinical effectiveness of internal fixation and external fixator for the treatment of unstable distal radius fractures. METHODS:The relative databases and literatures were searched with the computer and hand to col ect the randomized control ed trials of internal fixation versus external fixator for the treatment of unstable distal radius fractures. After extraction literature data and quality evaluation, RevMan 5.2 software was used for system evaluation. The grip strength, disabilities of arm, shoulder&hand score, complications rates, infection rates, deformity rates and ulnar variance rates were compared between two groups. RESULTS AND CONCLUSION:A total of 9 literatures, involving total y 524 patients were included, 286 patients in the internal fixation group and 238 patients in the external fixator group. There was no significant difference in grip strength between internal fixation group and the external fixator group. The results of Meta-analysis showed that the internal fixation group was better than the external fixator group in the aspects of disabilities of arm, shoulder&hand score, complications rate, infection rate, deformity rate and ulnar variance rate at 3 months and 1 year after treatment. The results indicate that the plate internal fixation is better than external fixator in the treatment of unstable distal radius fractures, but the large sample, double-blind, and high quality randomized control ed trials are stil needed to identify the results.