CAJ | 학술논문

目的应用Meta分析方法评价肱骨髁间骨折采用双钢板垂直固定与平行固定的疗效差异,为临床选择治疗方法提供依据. 方法计算机检索PubMed、EMbase、Cochrane图书馆、中国生物医学文献数据库、万方数据库及中国知网,查找所有比较双钢板垂直固定与平行固定治疗肱骨髁间骨折的随机对照研究(RCTs),检索时间均为建库至2014年9月,同时手工检索纳入文献的参考文献.按纳入排除标准进行RCTs的筛选、资料提取和质量评价后,采用RevMan5.1软件进行Meta分析,并采用GRADE系统进行证据质量评价. 结果共纳入8项研究389例患者,均为RCT.Meta分析结果显示:双钢板垂直固定与双钢板平行固定的手术时间、骨折愈合时间、术后并发症、肘关节屈伸活动度、前臂旋转活动度、术后Mayo肘关节功能评分及Cassebaum评分比较,差异均无统计学意义(P＞0.05).采用GRADE系统推荐分级方法评价证据质量及推荐等级:证据质量为中级,推荐等级为中等推荐. 结论肱骨髁间骨折双钢板垂直固定与双钢板平行固定临床效果相当,均能达到稳定的固定效果.
목적 응용Meta분석방법평개굉골과간골절채용쌍강판수직고정여평행고정적료효차이,위림상선택치료방법제공의거. 방법 계산궤검색PubMed、EMbase、Cochrane도서관、중국생물의학문헌수거고、만방수거고급중국지망,사조소유비교쌍강판수직고정여평행고정치료굉골과간골절적수궤대조연구(RCTs),검색시간균위건고지2014년9월,동시수공검색납입문헌적삼고문헌.안납입배제표준진행RCTs적사선、자료제취화질량평개후,채용RevMan5.1연건진행Meta분석,병채용GRADE계통진행증거질량평개. 결과 공납입8항연구389례환자,균위RCT.Meta분석결과현시:쌍강판수직고정여쌍강판평행고정적수술시간、골절유합시간、술후병발증、주관절굴신활동도、전비선전활동도、술후Mayo주관절공능평분급Cassebaum평분비교,차이균무통계학의의(P＞0.05).채용GRADE계통추천분급방법평개증거질량급추천등급:증거질량위중급,추천등급위중등추천. 결론 굉골과간골절쌍강판수직고정여쌍강판평행고정림상효과상당,균능체도은정적고정효과.
Objective To systematically compare the efficacy of perpendicular plating versus parallel plating in the treatment of intercondylar humeral fractures.Methods Such databases as PubMed,EMbase,Cochrane Library,Chinese Biomedical Literature Database,WANFANG database and China National Knowledge Infrastructure were searched from their establishment to September 2014 for the randomized controlled trials (RCTs) investigating perpendicular plating versus parallel plating in the treatment of intercondylar humeral fractures.The references of the RCTs included were also searched by hand.The retrieved RCTs were screened by inclusion and exclusion criteria before data extraction and quality assessment.The meta-analyses were performed using the software RevMan5.1.The level of evidence was assessed by the GRADE system.Results Eight RCTs involving 389 patients were included.The meta-analyses showed no statistically significant differences between perpendicular plating and parallel plating in operation time,fracture healing time,postoperative complications,elbow flexion and extension,forearm rotation,postoperative Mayo Elbow Performance Score or Cassebaum score (P ＞ 0.05).According to the GRADE system,all the evidence was at intermediate level and for moderate recommendation.Conclusions Both perpendicular plating and parallel plating can lead to similarly effective treatment of intercondylar humeral fractures.Both of them can achieve stable fixation.