摘要
目的通过Meta分析系统评价双钢板(dual plate,DP)与单侧锁定钢板(single lateral locking plate,SP)内固定治疗复杂胫骨平台骨折(Tibial plateau fracture,TPF)(SchatzkerⅣ~Ⅵ型)的临床疗效。方法运用计算机检索PubMed、Embase、Cochrane Library、中国知网、万方和维普数据库,收集自2015年7月5日至2020年7月5日间采用DP和SP内固定治疗复杂TPF(SchatzkerⅣ~Ⅵ型)疗效对比的随机对照研究,制定入选和剔除标准,筛选出符合纳入标准的文献,评价纳入研究的方法学质量,使用RevMan 5.3软件进行Meta分析。结果最终纳入17篇文献,包括1326名患者,DP组和SP组各663名。Meta分析结果表明,两组术式在手术时间、术中出血量、骨折愈合时间及住院时间方面均无显著统计学差异(P>0.05);DP组术后并发症较少[RR=0.47,95%CI(0.35,0.64),P<0.00001],SP组膝关节功能Rasmussen评分优于DP组[MD=1.14,95%CI(1.05,1.23),P=0.001],且HSS评分也优于DP组[MD=2.36,95%CI(1.13,4.91),P=0.02]。结论DP和SP内固定均是治疗此类骨折的有效方法,同时也是治疗复杂TPF的最佳治疗策略,未来仍需更多高质量的随机对照试验和长期临床评估加以验证。
Objective To evaluate the clinical efficacy of double plate(DP)and single locking plate(SP)internal fixation in the treatment of complex tibial plateau fractures(SchatzkerⅣ~VI)by Meta analysis system.Methods The databases of PubMed,Embase,CochraneLibrary,CNKI,Wanfang and VIP were searched by computer,and the randomized controlled trials of DP and SP internal fixation in the treatment of complex tibial plateau fractures(SchatzkerⅣ~VI)from July 5,2015 to July 5,2020 were collected.The inclusion and exclusion criteria were established,the literatures that met the inclusion criteria were selected,and we evaluated the methodological quality of the study.RevMan5.3 software was used for Meta analysis.Results Seventeen articles were included,including 1326 patients,including DP group(n=663)and SP group(n=663).The results of Meta analysis showed that there was no significant difference in operation time,intraoperative blood loss,fracture healing time and hospital stay between the two groups(P>0.05).There were fewer postoperative complications in DP group[RR=0.47,95%CI(0.35,0.64),P<0.00001].The Rasmussen score of knee joint function in SP group was better than that in DP group[MD=1.14,95%CI(1.05,1.23),P=0.001],and HSS score was also better than that in DP group[MD=2.36,95%CI(1.13,4.91),P=0.02].Conclusion Both DP and SP internal fixation are effective methods to treat this kind of fracture,more high-quality randomized controlled trials and long-term clinical evaluation are needed to verify the best treatment strategy for complex tibial plateau fractures in the future.
作者
张顶顶
涂振兴
申晓阳
张照林
刘文龙
孙晓新
ZHANG Ding-ding(Department of orthopedics, affiliated hospital of north China university of science and technology,Tangshan 063000, China)
出处
《牡丹江医学院学报》
2021年第4期129-134,共6页
Journal of Mudanjiang Medical University
关键词
双钢板
单侧锁定钢板
胫骨平台骨折
META分析
double plate
single lateral locking plate
tibial plateau fracture
Meta analysis
