中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2014年
17期
2770-2776
,共7页
努尔哈那提?沙依兰别克%李忠伟%金格勒%杨德盛%杨毅
努爾哈那提?沙依蘭彆剋%李忠偉%金格勒%楊德盛%楊毅
노이합나제?사의란별극%리충위%금격륵%양덕성%양의
植入物%骨科植入物%桡骨远端骨折%内固定%手术治疗%老年人%非手术治疗
植入物%骨科植入物%橈骨遠耑骨摺%內固定%手術治療%老年人%非手術治療
식입물%골과식입물%뇨골원단골절%내고정%수술치료%노년인%비수술치료
radius%radius fractures%internal fixators%aged
背景：目前老年桡骨远端骨折是否需切开复位钢板内固定以恢复影像学上的解剖复位还存在争议。目的：对老年人桡骨远端骨折手术与非手术治疗的疗效进行系统评价。<br> 方法：计算机检索 PubMed，Springer 以及万方等数据库，手工检索相关的中英文骨科杂志。收集所有对手术与非手术治疗老年人桡骨远端骨折疗效进行比较的文献。利用Cochrane协作网提供的RevMan5.0软件进行统计学分析。<br> 结果与结论：共纳入符合标准的文献6篇，其中随机对照研究2篇，回顾性队列研究4篇。Meta分析结果显示：两组腕关节背伸活动度[MD=-0.87，95% CI(-3.31,1.58)， P=0.49]，屈曲活动度[MD=-2.79，95%CI(-6.47,0.88)，P=0.14]，旋前活动度[MD=-0.08，95%CI(-1.49,1.64)，P=0.92]，旋后活动度[MD=-0.7，95%CI(-3.52，2.12)，P=0.63]以及并发症的发生[MD=1.35，95%CI(0.71,2.56)，P=0.36]差异均无显著性意义；手术组桡骨长度更接近于正常的解剖长度[MD=2.46，95% CI(1.78,3.15)，P <0.01]；手术组尺倾角[MD=3.73，95%CI(2.97，4.48)，P<0.00001]以及掌倾角[MD=6.81，95%CI(3.72,9.90)，P<0.0001]更接近于正常的解剖角度。两组患肢腕关节屈伸，旋前旋后活动度以及并发症的发生差异均无显著性意义，而手术组解剖复位程度明显优于非手术组。
揹景：目前老年橈骨遠耑骨摺是否需切開複位鋼闆內固定以恢複影像學上的解剖複位還存在爭議。目的：對老年人橈骨遠耑骨摺手術與非手術治療的療效進行繫統評價。<br> 方法：計算機檢索 PubMed，Springer 以及萬方等數據庫，手工檢索相關的中英文骨科雜誌。收集所有對手術與非手術治療老年人橈骨遠耑骨摺療效進行比較的文獻。利用Cochrane協作網提供的RevMan5.0軟件進行統計學分析。<br> 結果與結論：共納入符閤標準的文獻6篇，其中隨機對照研究2篇，迴顧性隊列研究4篇。Meta分析結果顯示：兩組腕關節揹伸活動度[MD=-0.87，95% CI(-3.31,1.58)， P=0.49]，屈麯活動度[MD=-2.79，95%CI(-6.47,0.88)，P=0.14]，鏇前活動度[MD=-0.08，95%CI(-1.49,1.64)，P=0.92]，鏇後活動度[MD=-0.7，95%CI(-3.52，2.12)，P=0.63]以及併髮癥的髮生[MD=1.35，95%CI(0.71,2.56)，P=0.36]差異均無顯著性意義；手術組橈骨長度更接近于正常的解剖長度[MD=2.46，95% CI(1.78,3.15)，P <0.01]；手術組呎傾角[MD=3.73，95%CI(2.97，4.48)，P<0.00001]以及掌傾角[MD=6.81，95%CI(3.72,9.90)，P<0.0001]更接近于正常的解剖角度。兩組患肢腕關節屈伸，鏇前鏇後活動度以及併髮癥的髮生差異均無顯著性意義，而手術組解剖複位程度明顯優于非手術組。
배경：목전노년뇨골원단골절시부수절개복위강판내고정이회복영상학상적해부복위환존재쟁의。목적：대노년인뇨골원단골절수술여비수술치료적료효진행계통평개。<br> 방법：계산궤검색 PubMed，Springer 이급만방등수거고，수공검색상관적중영문골과잡지。수집소유대수술여비수술치료노년인뇨골원단골절료효진행비교적문헌。이용Cochrane협작망제공적RevMan5.0연건진행통계학분석。<br> 결과여결론：공납입부합표준적문헌6편，기중수궤대조연구2편，회고성대렬연구4편。Meta분석결과현시：량조완관절배신활동도[MD=-0.87，95% CI(-3.31,1.58)， P=0.49]，굴곡활동도[MD=-2.79，95%CI(-6.47,0.88)，P=0.14]，선전활동도[MD=-0.08，95%CI(-1.49,1.64)，P=0.92]，선후활동도[MD=-0.7，95%CI(-3.52，2.12)，P=0.63]이급병발증적발생[MD=1.35，95%CI(0.71,2.56)，P=0.36]차이균무현저성의의；수술조뇨골장도경접근우정상적해부장도[MD=2.46，95% CI(1.78,3.15)，P <0.01]；수술조척경각[MD=3.73，95%CI(2.97，4.48)，P<0.00001]이급장경각[MD=6.81，95%CI(3.72,9.90)，P<0.0001]경접근우정상적해부각도。량조환지완관절굴신，선전선후활동도이급병발증적발생차이균무현저성의의，이수술조해부복위정도명현우우비수술조。
BACKGROUND:At present, it remains controversial whether open reduction plate fixation is needed for distal radius fracture in the elderly to restore anatomic reduction of imaging. <br> OBJECTIVE:To systematical y evaluate the curative effects of operative and nonoperative treatments for distal radius fractures in the elderly. <br> METHODS:We retrieved PubMed, Springer and Wanfang database using computer. Relevant English and Chinese journals of orthopedics were retrieved by hand. Al literatures on curative effects of operative and nonoperative treatments for distal radius fractures in the elderly were col ected. RevMan 5.0 software provided by Cochrane was used to statistical y analyze the data. <br> RESULTS AND CONCLUSION:Six literatures were included, including two of randomized control ed study and four of retrospective cohort study. Meta-analysis results displayed that there were no significant differences in both groups in range of motion of wrist joint extension [mean difference (MD)=-0.87, 95%confidence interval (CI) (-3.31, 1.58), P=0.49], range of motion of wrist joint flexion [MD=-2.79, 95%CI(-6.47, 0.88), P=0.14], range of motion of wrist pronation [MD=-0.08, 95%CI(-1.49, 1.64), P=0.92], range of motion of supination [MD=-0.7, 95%CI(-3.52, 2.12), P=0.63] and the occurrence of complication [MD=1.35, 95%CI(0.71, 2.56), P=0.36]. The length of radius in the surgery group was similar to that of normal [MD=2.46, 95%CI(1.78, 3.15), P<0.01]. Ulnar inclination [MD=3.73, 95%CI(2.97, 4.48), P<0.000 01] and palmar tilt angle [MD=6.81, 95%CI(3.72, 9.90), P<0. 000 1] in the surgery group were close to that of normal. There are no significant differences in extension, flexion, pronation and supination activities of wrist and posttreatment complication between two groups. Operative treatment result is superior to that of nonoperative treatment in anatomic reduction.
