中国骨与关节外科
中國骨與關節外科
중국골여관절외과
CHINESE BONE AND JOINT SURGERY
2014年
2期
128-133
,共6页
刘鹏程%舒和喜%黄昌佳%杨云戟%刘润%杨勇%巩金鹏%蔡明
劉鵬程%舒和喜%黃昌佳%楊雲戟%劉潤%楊勇%鞏金鵬%蔡明
류붕정%서화희%황창가%양운극%류윤%양용%공금붕%채명
MasonⅢ%假体置换%桡骨小头骨折%内固定%临床结局%Meta分析
MasonⅢ%假體置換%橈骨小頭骨摺%內固定%臨床結跼%Meta分析
MasonⅢ%가체치환%뇨골소두골절%내고정%림상결국%Meta분석
MasonⅢ%Prosthetic replacement%Radial head fractures%Internal fixation%Clinical outcome%Meta-analysis
背景:对于MasonⅢ型桡骨头骨折,采用何种术式治疗一直是争论的焦点。<br> 目的:比较假体置换与切开复位内固定治疗MasonⅢ型桡骨头骨折的术后优良率、并发症、肘关节功能。<br> 方法:计算机检索PubMed(1950/2014-03)、OVID(1950/2014-03)、MEDLINE(1950/2014-03)、EMBASE(1980/2014-03)、CENTRAL(The Cochrane Library,1993/2014)、CBM(1978/2014-03)、万方数据库(1981/2014-03)、CNKI(1979/2014-03)、维普数据库(1989/2014-03)。搜集MasonⅢ型桡骨头骨折假体置换及切开复位内固定的对照研究并加以系统评价。用Revmen 5.1统计学软件进行异质性分析及Meta分析。<br> 结果:本研究最终纳入2篇随机对照试验和7篇临床对照试验,总计344例患者。采用假体置换155例,切开复位内固定189例。假体置换组优良率[OR=3.17,95%CI (1.78,5.65),P<0.0001],并发症[OR=0.22,95%CI(0.10,0.50),P=0.0003],Broberg-Morrey肘关节功能评分[WMD=12.43,95%CI (8.02,16.85),P<0.00001]与切开复位内固定组相比,均有明显优势。<br> 结论:现有的有限证据表明,通过优良率、肘关节功能评分及并发症评价证实人工假体置换治疗MasonⅢ型桡骨小头骨折较切开复位内固定具有更大优势,且差异具有统计学意义。受纳入文献数量和质量的限制,Meta分析结果尚有待与高质量的大样本随机对照试验予以证实。
揹景:對于MasonⅢ型橈骨頭骨摺,採用何種術式治療一直是爭論的焦點。<br> 目的:比較假體置換與切開複位內固定治療MasonⅢ型橈骨頭骨摺的術後優良率、併髮癥、肘關節功能。<br> 方法:計算機檢索PubMed(1950/2014-03)、OVID(1950/2014-03)、MEDLINE(1950/2014-03)、EMBASE(1980/2014-03)、CENTRAL(The Cochrane Library,1993/2014)、CBM(1978/2014-03)、萬方數據庫(1981/2014-03)、CNKI(1979/2014-03)、維普數據庫(1989/2014-03)。搜集MasonⅢ型橈骨頭骨摺假體置換及切開複位內固定的對照研究併加以繫統評價。用Revmen 5.1統計學軟件進行異質性分析及Meta分析。<br> 結果:本研究最終納入2篇隨機對照試驗和7篇臨床對照試驗,總計344例患者。採用假體置換155例,切開複位內固定189例。假體置換組優良率[OR=3.17,95%CI (1.78,5.65),P<0.0001],併髮癥[OR=0.22,95%CI(0.10,0.50),P=0.0003],Broberg-Morrey肘關節功能評分[WMD=12.43,95%CI (8.02,16.85),P<0.00001]與切開複位內固定組相比,均有明顯優勢。<br> 結論:現有的有限證據錶明,通過優良率、肘關節功能評分及併髮癥評價證實人工假體置換治療MasonⅢ型橈骨小頭骨摺較切開複位內固定具有更大優勢,且差異具有統計學意義。受納入文獻數量和質量的限製,Meta分析結果尚有待與高質量的大樣本隨機對照試驗予以證實。
배경:대우MasonⅢ형뇨골두골절,채용하충술식치료일직시쟁론적초점。<br> 목적:비교가체치환여절개복위내고정치료MasonⅢ형뇨골두골절적술후우량솔、병발증、주관절공능。<br> 방법:계산궤검색PubMed(1950/2014-03)、OVID(1950/2014-03)、MEDLINE(1950/2014-03)、EMBASE(1980/2014-03)、CENTRAL(The Cochrane Library,1993/2014)、CBM(1978/2014-03)、만방수거고(1981/2014-03)、CNKI(1979/2014-03)、유보수거고(1989/2014-03)。수집MasonⅢ형뇨골두골절가체치환급절개복위내고정적대조연구병가이계통평개。용Revmen 5.1통계학연건진행이질성분석급Meta분석。<br> 결과:본연구최종납입2편수궤대조시험화7편림상대조시험,총계344례환자。채용가체치환155례,절개복위내고정189례。가체치환조우량솔[OR=3.17,95%CI (1.78,5.65),P<0.0001],병발증[OR=0.22,95%CI(0.10,0.50),P=0.0003],Broberg-Morrey주관절공능평분[WMD=12.43,95%CI (8.02,16.85),P<0.00001]여절개복위내고정조상비,균유명현우세。<br> 결론:현유적유한증거표명,통과우량솔、주관절공능평분급병발증평개증실인공가체치환치료MasonⅢ형뇨골소두골절교절개복위내고정구유경대우세,차차이구유통계학의의。수납입문헌수량화질량적한제,Meta분석결과상유대여고질량적대양본수궤대조시험여이증실。
Background:There is a certain controversy on the efficacy of different treatment modalities for Mason typeⅢradial head fracture. <br> Objective:To evaluate the clinical outcome, complications and eblow function of prosthetic replacement versus open reduc-tion and internal fixation for the treatment of MasonⅢradial head fracture. <br> Methods:We searched PubMed (1950/2014-03), OVID (1950/2014-03), MEDLINE (1950/2014-03), EMBASE (1980/2014-03), CENTRAL (The Cochrane Library, 1993/2014), CBM (1978/2014-03), Wangfang database (1981/2014-03), CNKI (1979/2014-03), and VIP (1989/2014-03). The literature on the treatment of Mason typeⅢradial head fracture by prosthet-ic replacement and open reduction and internal fixation were collected and the effects were compared through Meta analy-sis. RevMan 5.1 statistical software was used to perform the heterogeneity analysis and Meta analysis. <br> Results:Eventually, 7 controlled clinical trials and 2 randomized controlled trails including 344 cases were enrolled in this study. Of them, 155 patients underwent prosthetic replacement and 189 patients received open reduction and internal fixa-tion. The good rate [OR=3.17, 95%CI (1.78, 5.65), P<0.0001], incidence of complications [OR=0.22, 95%CI (0.10, 0.50), P=0.0003] and elbow function recovery [WMD=12.43, 95%CI (8.02, 16.85), P<0.00001] in the patients undergoing pros-thetic replacement were statistically superior to those with open reduction and internal fixation. <br> Conclusions: Compared with open reduction and internal fixation, prosthetic replacement is statistically superior in good rate, complication rate and eblow function for treating Mason typeⅢradial head fracture. Further well-designed and large-scale randomized controlled trials are required to confirm these findings.