中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (17): 3130-3133.doi: 10.3969/j.issn.1673-8225.2012.17.021

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

扩髓与非扩髓髓内钉置入固定治疗成人闭合性胫骨干骨折的Meta分析★

王  磊1，陈根元1，王凤凤2，何玉萍3，王  涛3   

  1. 1兰州大学第一临床医学院骨科，甘肃省兰州市730000；2西安长安医院骨科，陕西省西安市710016；3兰州大学第二临床医学院，甘肃省兰州市730000
  • 收稿日期:2011-09-29 修回日期:2011-11-05 出版日期:2012-04-22 发布日期:2012-04-22
  • 通讯作者: 陈根元，教授，兰州大学第一临床医学院骨科，甘肃省兰州市 730000 chengenyuan2009@163.com
  • 作者简介:王磊★，男，1980年生，陕西省延安市人，汉族，兰州大学第一临床医学院在读硕士，主要从事骨科方面的研究。 wangleizhuimeng@163.com

Meta analysis of reamed versus non-reamed intramedullary nailing for closed tibial fractures in adults 

Wang Lei1, Chen Gen-yuan1, Wang Feng-feng2, He Yu-ping3, Wang Tao3   

  1. 1Department of Orthopedics, First Clinical Medical College of Lanzhou University, Lanzhou 730000, Gansu Province, China; 2Department of Orthopedics, Xi’an Chang’an Hospital, Xi’an  710016, Shaanxi Province, China; 3Second Clinical Medical College of Lanzhou University, Lanzhou  730000, Gansu Province, China
  • Received:2011-09-29 Revised:2011-11-05 Online:2012-04-22 Published:2012-04-22
  • Contact: Chen Gen-yuan, Professor, Department of Orthopedics, First Clinical Medical College of Lanzhou University, Lanzhou 730000, Gansu Province, China chengenyuan2009@163.com
  • About author:Wang Lei★, Studying for master’s degree, Department of Orthopedics, First Clinical Medical College of Lanzhou University, Lanzhou 730000, Gansu Province, China wangleizhuimeng@163.com

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摘要：

背景：一些对照研究试图回答扩髓与非扩髓髓内钉治疗胫骨闭合性骨折的优劣问题，得出结论各不相同。
目的：对成人闭合性胫骨干骨折扩髓与非扩髓髓内钉固定的疗效进行Meta分析。
方法：计算机检索PubMed、Embase、Cochrane图书馆及中国生物医学数据库、维普信息数据库、万方数据库。收集扩髓与非扩髓髓内钉固定相比较治疗成人闭合性胫骨干骨折的随机对照试验，并评价纳入研究的方法学质量。统计软件用Cochrane协作网提供的RevMan 5.0。
结果与结论：共纳入3个随机对照临床试验。Meta分析表明，扩髓髓内钉与非扩髓髓内钉固定治疗成人胫骨干骨折比较，其骨折不愈合率降低[RR 0.25，95%CI(0.08，0.79)，P=0.02]，内置物失效率显著降低[RR 0.25，95%CI(0.12，0.52) P=0.000 2]。说明与非扩髓髓内钉固定相比较，扩髓髓内钉固定治疗成人闭合性胫骨干骨折时骨折不愈合率及内置物失效更少见。扩髓与否在骨折延迟愈合率、畸形愈合率、骨筋膜室综合征发生率方面差异无显著性意义。
关键词：闭合性胫骨骨折；骨折固定术；髓内钉；随机对照试验；Meta分析
doi:10.3969/j.issn.1673-8225.2012.17.021

关键词: 闭合性胫骨骨折, 骨折固定术, 髓内钉, 随机对照试验, Meta分析

Abstract:

BACKGROUND: Some control studies attempt to answer the advantages and disadvantages of the issue on reamed and non-reamed intramedullary nailing for closed tibial fractures, but the conclusions are different.
OBJECTIVE: To determine the efficiency and safety of reamed versus non-reamed intramedullary nailing for closed tibial fractures in adults by Meta analysis.
METHODS: PubMed, Embase, Cochranel Library, CBMdisc, Weipu information database and Wanfang were searched by computer. Randomized controlled trials related to reamed versus non-reamed intramedulary nailing for closed tibial fractures in adults were included. The quality of trials was critically assessed. RevMan 5.0 software was used for data analysis．
RESULTS AND CONCLUSION: Three randomized controlled trials were included. Meta analysis showed that compared with the non-reamed intramedulary nailing for closed tibial fractures in adults, the nonunion rate decreased [RR 0.25, 95%CI(0.08, 0.79), P=0.02] and implant failure rate decreased significantly [RR 0.25, 95%CI(0.12, 0.52) P=0.000 2] in the reamed intramedullary nailing for closed tibial fractures in adults. Compared with non-reamed intramedulary nailing for closed tibial fractures in adults, reamed intramedulary nailing decreases the nonunion rate and implant failure are rare. There is no statistical difference in the rate of delayed fracture healing, malunion rate and the incidence of compartment syndrome.

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