中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (35): 6487-6490.doi: 10.3969/j.issn.1673-8225.2010.35.007

• 骨与关节循证医学 evidence-based medicine of the bone and joint • 上一篇    下一篇

闭合性肱骨干骨折患者小夹板外固定与植入物内固定治疗比较的Meta分析

杨  拯1，袁梦郎2，邱有波2，张  晓1   

  1. 1成都医学院实验技术教研室，四川省成都市 610081；2成都医学院2008级临床医学本科班，四川省成都市 610081
  • 出版日期:2010-08-27 发布日期:2010-08-27
  • 作者简介:杨拯，男，1980年生，四川省苍溪县人，汉族，2005年成都医学院毕业，助教，主要从事《机能实验学》教学工作和临床疾病治疗研究。 yz3191021@yahoo.com.cn

Small splint external fixation versus internal fixation implants for the treatment of closed humeral shaft fracture: A Meta-analysis

Yang Zheng1, Yuan Meng-lang2, Qiu You-bo2, Zhang Xiao1   

  1. 1 Department of Experimental Technology, Chengdu Medical College, Chengdu   610081, Sichuan Province, China; 2 Preclinical Medicine School, Chengdu Medical College, Chengdu 610081, Sichuan Province, China
  • Online:2010-08-27 Published:2010-08-27
  • About author:Yang Zheng, Teaching assistant, Department of Experimental Technology, Chengdu Medical College, Chengdu 610081, Sichuan Province, China yz3191021@yahoo.com.cn

PDF

349

被引次数

13

摘要：

背景：目前常用的肱骨干骨折治疗方法有小夹板、石膏、功能性支架等外固定方法与钢板螺钉、髓内针等内固定治疗，每种方法达到骨愈合的生物学机制均不相同，因而各有其独特的临床适应证。
目的：利用Meta分析方法在较大样本量的前提下，比较国内应用小夹板外固定与钢板螺钉、髓内针或双克氏针等置入内固定治疗闭合性肱骨干骨折的有效性。
方法：计算机检索Medline、中国生物医学文献数据库、中国期刊全文数据库、西文生物医学期刊文献数据库、维普中文科技期刊数据库相关文章。对结果进行Meta分析。其中实验组行小夹板外固定，对照组行钢板螺钉、髓内针、双克氏针等置入内固定。疗效及差异评价指标以优势比，加权均数差和95% CI表示。
结果与结论：有7个临床对照研究符合纳入标准，共纳入患者1 390例，其中行小夹板外固定的实验组患者1 007例，钢板螺钉、髓内针、双克氏针等置入内固定的对照组患者383例。Meta分析显示：①实验组骨折复位优良率、骨折愈合时间、骨折未愈合率、低于对照组[OR=0.20，95%CI(0.03，1.20)，P=0.08；OR=-33.69，95%CI(-44.67，-22.72)，P < 0.000 01；OR=0.31，95%CI (0.16，0.60)， P=0.000 5]。②实验组骨折正常愈合率、肩肘关节功能恢复优良率高于对照组[OR=3.04，95%CI(1.95，4.75)，P < 0.000 01；OR=8.02，95%CI (2.68，24.04)，P=0.000 2]。提示小夹板外固定治疗闭合性肱骨干骨折是安全有效的，较植入物内固定在治疗闭合性肱骨干骨折中具有更好的临床效果。

关键词: 肱骨干骨折, 小夹板, 外固定, 内固定, 医学植入物, Meta分析

Abstract:

BACKGROUND: The humeral shaft fractures are commonly treated with small splints, plaster, functional scaffold external fixation and internal fixation of plates and screws, intramedullary nails and so on. But each treatment approach to the biological mechanisms of bone healing is different. Therefore, each has its unique clinical indications.
OBJECTIVE: To compare efficacy between small splint external fixation and internal fixation of plates and screws, intramedullary nails and kirschner wires for the treatment of closed humeral shaft fracture by using Meta-analysis.
METHODS: Computer-based online search of Medline, CBM, CNKI, EMCC, and VIP  databases was performed to collect related articles with the test group treated with small splint external fixation, while control group with internal fixation of plates and screws, intramedullary nails and kirschner wires. Differences in efficacy and evaluation indicators were odds ratio (OR), weighted mean difference and 95% confidence interval (CI).
RESULTS: A total of 7 clinically controlled studies were included in the final analysis containing 1 390 patients. Among the patients, 1 007 cases were treated with small splint external fixation and 383 with internal fixation. All the 7 controls were performed with Meta-analysis. ①Fracture reduction excellent rate, fracture union tie, nonunion rate of experimental group were less than control [OR=0.20, 95%CI (0.03,1.20), P=0.08; OR=-33.69, 95%CI (-44.67, -22.72), P < 0.000 01; OR=0.31, 95%CI (0.16,0.60), P=0.000 5]. ②Fractures normal union rate and functional of shoulder and elbow joints excellent rate of experimental group were greater than control [OR=3.04, 95%CI(1.95,4.75), P < 0.000 01, OR=8.02,95%CI (2.68,24.04), P=0.000 2]. Meta-analysis results demonstrated that small splint external fixation is safe and effective. Additionally, clinical efficacy of small splint external fixation was superior to that of internal fixation of plates and screws, intramedullary nails and kirschner wires.

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