[1]何文,郑明,冯尔宥,等.闭合复位经皮克氏针内固定术与切开复位克氏针内固定术治疗儿童GartlandⅡ、Ⅲ型肱骨髁上骨折的疗效及安全性系统评价[J].中医正骨,2017,29(04):23-30.
　HE Wen,ZHENG Ming,FENG Eryou,et al.Systematic review on the curative effect and safety of closed reduction and percutaneous internal fixation with Kirschner wire versus open reduction ……[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(04):23-30.
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闭合复位经皮克氏针内固定术与切开复位克氏针内固定术治疗儿童GartlandⅡ、Ⅲ型肱骨髁上骨折的疗效及安全性系统评价()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期数:
2017年04期
页码:
23-30
栏目:
文献研究
出版日期:
2017-04-20

文章信息/Info

Title:
Systematic review on the curative effect and safety of closed reduction and percutaneous internal fixation with Kirschner wire versus open reduction ……
作者:
何文1; 郑明1; 冯尔宥1; 林煜1; 张怡元1; 范超领2; 徐杰3
1.福建省福州市第二医院,福建 福州 350007; 2.福建中医药大学骨伤学院,福建 福州 350122; 3.福建医科大学省立临床医学院,福建 福州 350001
Author(s):
HE Wen1; ZHENG Ming1; FENG Eryou1; LIN Yu1; ZHANG Yiyuan1; FAN Chaoling2; XU Jie3
1.The Second Hospital of Fuzhou City,Fuzhou 350007,Fujian,China 2.The College of Traumatology and Orthopedics of Fujian University of Traditional Chinese Medicine,Fuzhou 350122,Fujian,China 3.The Provincial Clinical Medical College of Fujian Medical University,Fuzhou 350001,Fujian,China
关键词:
Meta分析;  系统评价;  肱骨髁上骨折;  儿童;  闭合复位术;  切开复位术;  克氏针
Keywords:
Key words Meta-Analysis;  systematic review;  supracondylar fracture of humerus;  Child;  closed reduction;  open reduction;  Kirschner wire
摘要:
目的:评价闭合复位经皮克氏针内固定术与切开复位克氏针内固定术治疗儿童GarlandⅡ、Ⅲ型肱骨髁上骨折(supracondylar fracture of humerus,SCHF)的疗效和安全性。方法:通过计算机检索Medline、PubMed、The Cochrane Library(2015年第10期)、CBM、CNKI、WanFang Data、VIP建库至2015年10月国内外公开发表的所有闭合复位经皮克氏针内固定术与切开复位克氏针内固定术治疗儿童GarlandⅡ、Ⅲ型SCHF的随机对照试验或半随机对照试验文献,同时手工检索本专业相关期刊从创刊至2015年10月的所有相关文献。由2位检索员独立筛选文献、提取资料、依据Cochrane系统进行文献方法学质量评价后,采用RevMan5.2软件进行Meta分析。结果:共检索出相关文献559篇,最终纳入14篇文献,仅1篇文献为随机对照试验,其余均为半随机对照试验; 共涉及917例患者,其中闭合复位组471例、切开复位组446例。Meta分析结果显示,闭合复位组与切开复位组在术后Flynn肘关节功能优良率、肘关节屈伸活动度及手术时间方面比较,组间差异均无统计学意义[OR=1.460,95%CI(0.95,2.25),Z=1.750,P=0.080; MD=0.570,95%CI(-8.69,9.83),Z=0.120,P=0.900; MD=-6.350,95%CI(-64.07,51.37),Z=0.220,P=0.830]; 在术后发生肘内翻、针道或切口感染、尺神经损伤及骨化性肌炎方面比较,组间差异均无统计学意义[OR=0.870,95%CI(0.35,2.20),Z=0.290,P=0.770; OR=0.620,95%CI(0.31,1.21),Z=1.400,P=0.160; OR=1.980,95%CI(0.88,4.49),Z=1.640,P=0.100; OR=0.150,95%CI(0.02,1.39),Z=1.670,P=0.100]。结论:对于儿童GarlandⅡ、Ⅲ型SCHF,闭合复位经皮克氏针内固定术与切开复位克氏针内固定术在临床疗效、安全性、手术时间方面均无明显差异,这可能与本研究所纳入的符合条件的文献数量较少及其方法学质量普遍偏低有关。
Abstract:
ABSTRACT Objective:To evaluate the curative effect and safety of closed reduction and percutaneous internal fixation with Kirschner wire versus open reduction and internal fixation with Kirschner wire for treatment of Gartland typeⅡand Ⅲ supracondylar fractures of humerus(SCHF)in children.Methods:All the randomized controlled trial(RCT)articles and controlled clinical trial(CCT)articles about closed reduction and percutaneous internal fixation with Kirschner wire versus open reduction and internal fixation with Kirschner wire for treatment of Gartland typeⅡandⅢSCHF in children that published at home and abroad included from database establishing to October 2015 were retrieved from Medline,PubMed,the Cochrane Library(2015,No.10),CBM,China national knowledge internet,WanFang Database and VIP Database through computer.Meanwhile,all the relevant articles published in relevant orthopedic journals included from journal establishing to October 2015 were manual retrieved.The articles were screened and the information was extracted independently by two searchers.The methodological quality of research in the articles was evaluated by using Cochrane system and a Meta-analysis was conducted by using Revman 5.2 software.Results:Five hundred and fifty-nine articles were searched out.After screening,14 trials(917 patients)were included in the final analysis,including one RCT and 13 CCT,471 patients in closed reduction group and 446 patients in open reduction group.The result of Meta-analysis demonstrated that there was no statistical difference in postoperative Flynn elbow joint function,postoperative flexion-extension range of elbow joint and operative time between the 2 groups[OR=1.460,95%CI(0.95,2.25),Z=1.750,P=0.080; MD=0.570,95%CI(-8.69,9.83),Z=0.120,P=0.900; MD=-6.350,95%CI(-64.07,51.37),Z=0.220,P=0.830],and there was no statistical difference in the incidence rate of postoperative complications including cubitus varus,pin hole or incision infection,ulnar nerve injury and myositis ossificans between the 2 groups[OR=0.870,95%CI(0.35,2.20),Z=0.290,P=0.770; OR=0.620,95%CI(0.31,1.21),Z=1.400,P=0.160; OR=1.980,95%CI(0.88,4.49),Z=1.640,P=0.100; OR=0.150,95%CI(0.02,1.39),Z=1.670,P=0.100].Conclusion:For children with Gartland typeⅡandⅢ SCHF,there is no significant difference in clinical curative effect,safety and operative time between closed reduction percutaneous internal fixation with Kirschner wire and open reduction internal fixation with Kirschner wire.However,less articles met the screening standard in our study and the quality of them was generally poor in methodology, so our conclusion has some limitations.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(81302986) 通讯作者:郑明 E-mail:zm_1964@126.com
更新日期/Last Update: 1900-01-01