中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (13): 2384-2388.doi: 10.3969/j.issn.1673-8225.2012.13.025

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

经皮螺钉置入固定与石膏固定治疗急性无移位性腕舟骨骨折的系统评价★

刘  伟1，赵劲民1，苏  伟1，唐士婷2，熊  凯1   

  1. 1广西医科大学第一附属医院创伤骨科手外科，广西壮族自治区南宁市  530021；2 广西壮族自治区人民医院神经内科，广西壮族自治区南宁市  530021
  • 收稿日期:2011-09-20 修回日期:2011-10-03 出版日期:2012-03-25 发布日期:2012-03-25
  • 通讯作者: 赵劲民，教授，博士生导师，广西医科大学第一附属医院创伤骨科手外科，广西壮族自治区南宁市 530021 zhaojinmin@126.com
  • 作者简介:刘伟★，男，1986年生，江西省萍乡市人，汉族，广西医科大学在读硕士，主要从事创伤骨科手外科疾病研究。 jxgxliuwei@163.com

Percutaneous screw insert fixation versus cast immobilization treatment for acute nondisplaced carpal scaphoid fracture: A systematic review   

Liu Wei1, Zhao Jin-min1, Su Wei1, Tang Shi-ting2, Xiong Kai1   

  1. 1Department of Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning  530021, Guangxi Zhuang Autonomous Region, China; 2Department of Neurology, Guangxi Zhuang Autonomous Region People’s Hospital, Nanning  530021, Guangxi Zhuang Autonomous Region, China
  • Received:2011-09-20 Revised:2011-10-03 Online:2012-03-25 Published:2012-03-25
  • Contact: author: Zhao Jin-min, Professor, Doctoral supervisor, Department of Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China zhaojinmin@126.com
  • About author:Liu Wei★, Studying for master’s degree, Department of Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China jxgxliuwei@163.com

PDF

309

被引次数

11

摘要：

背景：国内外在经皮螺钉置入固定与石膏固定治疗急性无移位性腕舟骨骨折方面有较多的临床经验，但尚缺乏循证医学方面的依据。
目的：系统评价经皮螺钉置入固定与石膏固定治疗急性无移位性腕舟骨骨折的疗效和安全性。
方法：计算机检索Medline、EMBASE、Cochrane library、中国期刊全文数据库、中国生物医学文献数据库，有关国内外已发表的采用经皮螺钉置入固定与石膏固定治疗急性无移位性腕舟骨骨折的随机对照试验。
结果与结论：纳入4个随机对照试验，175例患者。Meta分析表明，与石膏固定相比，经皮螺钉置入固定可缩短骨折愈合时间[SMD=-8.83，95%CI(-10.45，-7.21)， P < 0.000 01]，减少重返工作时间[MD=-6.86，95%CI (-7.17，-6.56)，P < 0.000 01]，较好恢复腕关节活动[SMD=1.79，95%CI (1.23，2.36)，P < 0.000 01]，提高握持力 [MD=3.53， 95%CI (2.52，4.54)，P < 0.000 01]；两组并发症发生率差异无显著性意义[RR=0.50， 95%CI(0.22，1.14)，P=0.10]。说明经皮螺钉置入固定治疗急性无移位性腕舟骨骨折疗效优于石膏固定治疗，由于该系统评价纳入研究数量和质量的局限性，对于两者的疗效和安全性分析尚需更多高质量的大样本随机对照试验进一步证实。
关键词：舟骨骨折；经皮螺钉置入固定；石膏固定；系统评价；Meta分析
doi:10.3969/j.issn.1673-8225.2012.13.025

关键词: 舟骨骨折, 经皮螺钉置入固定, 石膏固定, 系统评价, Meta分析

Abstract:

BACKGROUND: There are some clinical experiences for percutaneous screw insert fixation and cast immobilization treatment for acute nondisplaced carpal scaphoid fracture. However, relevant evidence-based medicine studies are rare. 
OBJECTIVE: To assess the effectiveness and safety of percutaneous screw insert fixation and cast immobilization treatment for acute nondisplaced carpal scaphoid fracture.
METHODS: Relevant domestic and abroad published randomized controlled trials (RCTs) of percutaneous screw insert fixation and cast immobilization treatment for acute nondisplaced carpal scaphoid fracture were searched from Medline, EMBASE, Cochrane library, CNKI and CBM databases by computer.
RESULTS AND CONCLUSION: Four randomized controlled trials (RCTs) involved 175 patients. The results of Meta-analysis showed that the fracture healing time (SMD=-8.83, 95%CI -10.45 to -7.21, P < 0.000 01) and off work time (MD=-6.86, 95%CI -7.17 to -6.56, P < 0.000 01) in the percutaneous screw insert fixation group were shorter than those in cast immobilization group; the wrist motion (SMD=1.79, 95%CI 1.23 to 2.36, P < 0.000 01) and grip strength (MD=3.53, 95%CI 2.52 to 4.54, P < 0.000 01) were better in the percutaneous screw insert fixation group; the differences of complications had no statistical significance (RR=0.50, 95%CI 0.22 to 1.14, P=0.10). It indicates that percutaneous screw insert fixation treatment for acute nondisplaced carpal scaphoid fracture is superior to cast immobilization treatment. Due to the small sample and limitation of quality in this review, the effectiveness and safety analysis are still needs more high quality and large scale samples of RCTs to get further confirm

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