CAJ | 학술논문

目的：采用Meta分析法对双Endobutton钢板与锁骨钩钢板治疗TossyⅢ型肩锁关节脱位的疗效进行对比，为其广泛的应用提供循证证据。方法检索Medline，EMbase，Cochrane Library，Springerlink、中国知识资源总库、万方数据库、维普数据库。检索时间为2006年1月—2014年5月。收集双Endobutton钢板与锁骨钩钢板治疗TossyⅢ型肩锁关节脱位的相关文献，按纳入与排除标准筛选文献并对纳入文献进行质量评价，采用RevMan5.2软件进行分析。结果共纳入31篇文献，病例数合计为1346例，其中双Endobutton钢板组618例，锁骨钩钢板组728例。结果显示在主要观察指标中，双Endobutton钢板组在术后疗效、术后关节活动正常概率均优于锁骨钩钢板组（P<0.0001）；在次要观察指标分析中，双Endobutton钢板组切口长度、术后肌力正常概率、Constant-Murley评分优于锁骨钩钢板组（P<0.05），其余两项指标锁骨钩钢板组优于双Endobutton钢板组（P<0.05）。结论双Endobutton钢板治疗TossyⅢ型肩锁关节脱位在疗效、术后疼痛风险、术后关节活动正常概率、切口长度、术后肌力正常概率方面优于锁骨钩钢板，而在手术时间、术中出血量方面劣于锁骨钩钢板。
목적：채용Meta분석법대쌍Endobutton강판여쇄골구강판치료TossyⅢ형견쇄관절탈위적료효진행대비，위기엄범적응용제공순증증거。방법검색Medline，EMbase，Cochrane Library，Springerlink、중국지식자원총고、만방수거고、유보수거고。검색시간위2006년1월—2014년5월。수집쌍Endobutton강판여쇄골구강판치료TossyⅢ형견쇄관절탈위적상관문헌，안납입여배제표준사선문헌병대납입문헌진행질량평개，채용RevMan5.2연건진행분석。결과공납입31편문헌，병례수합계위1346례，기중쌍Endobutton강판조618례，쇄골구강판조728례。결과현시재주요관찰지표중，쌍Endobutton강판조재술후료효、술후관절활동정상개솔균우우쇄골구강판조（P<0.0001）；재차요관찰지표분석중，쌍Endobutton강판조절구장도、술후기력정상개솔、Constant-Murley평분우우쇄골구강판조（P<0.05），기여량항지표쇄골구강판조우우쌍Endobutton강판조（P<0.05）。결론쌍Endobutton강판치료TossyⅢ형견쇄관절탈위재료효、술후동통풍험、술후관절활동정상개솔、절구장도、술후기력정상개솔방면우우쇄골구강판，이재수술시간、술중출혈량방면렬우쇄골구강판。
Objective To evaluate the effects of double Endobutton plate versus clavicular hook plate in the treatment of Tossy Ⅲ acromioclavicular dislocation. Methods Eligible studies were identified from electronic databases including Medline、EMbase、Cochrane Library、Springerlink, CNKI, WanFang Data and VIP. We screened the retrieved literature according to the inclusion and exclusion criteria and performed a Metaanalysis with the software RevMan 5.2 after identification of the relevant data. Results A total of 1246 patients from 29 studies were included for the analysis, including 570 patients who underwent double Endobutton plate surgeries and 676 patients who underwent clavicular hook plate surgeries. The double Endobutton plate group was significantly superior to the clavicular hook plate surgery group in regard to clinical outcome,incision length, postsurgical pain, average Constant-Murley scores (P<0.05). Clavicular hook plate group is better at less blood loss and shorter sugery time. Conclusion In management of TossyⅢ acromioclavicular separation, compared with clavicular hook plate, double Endobutton technique can result in better functional outcomes and less shoulder pain.