[1]王艺超,吴妞,袁慧敏,等.髓内固定与髓外固定治疗股骨转子下骨折的系统评价[J].中医正骨,2018,30(02):21-28.
　WANG Yichao,WU Niu,YUAN Huimin,et al.Intramedullary fixation versus extramedullary fixation for treatment of subtrochanteric fractures:A systematic review[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(02):21-28.
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髓内固定与髓外固定治疗股骨转子下骨折的系统评价()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期数:
2018年02期
页码:
21-28
栏目:
文献研究
出版日期:
2018-02-20

文章信息/Info

Title:
Intramedullary fixation versus extramedullary fixation for treatment of subtrochanteric fractures:A systematic review
作者:
王艺超1; 吴妞2; 袁慧敏1; 张凯凯1; 刘晋闽3
1.浙江中医药大学,浙江 杭州 310053; 2.成都中医药大学,四川 成都 610075; 3.浙江省中医院,浙江 杭州 310006
Author(s):
WANG Yichao1; WU Niu2; YUAN Huimin1; ZHANG Kaikai1; LIU Jinmin3
1.Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China 2.Chengdu Chinese Medical University,Chengdu 610075,Sichuan,China 3.Zhejiang Provincial Hospital of Traditional Chinese Medicine,Hangzhou 310006,Zhejiang,China
关键词:
髋骨折;  股骨转子下骨折;  骨折固定术; 髓内;  髓外固定;  Meta分析;  系统评价
Keywords:
Keywords hip fractures;  subtrochanteric fractures;  fracture fixation; intramedullary;  extramedullary fixation;  meta-analysis;  systematic review
摘要:
目的:比较髓内固定与髓外固定治疗股骨转子下骨折的临床疗效和安全性。方法:应用计算机检索PubMed、The Cochrane Library、Embase、CBM、CNKI、WanFang Data1980年9月至2017年9月国内外公开发表的比较髓内固定(髓内固定组)和髓外固定(髓外固定组)治疗股骨转子下骨折的随机对照研究文献、半随机对照研究文献或回顾性研究文献。由2位研究者独立筛选文献、提取资料,依据Cochrane手册进行文献方法学质量评价后,采用RevMan5.3软件进行Meta分析。结果:最初共检索出3410篇文献,经逐层筛选后最终纳入8篇文献,均为英文文献,5篇为随机对照研究、2篇为半随机对照研究、1篇为回顾性研究。纳入的研究对象共391例,髓内固定组225例、髓外固定组166例。Meta分析结果显示,髓内固定组和髓外固定组的手术时间、术中失血量、住院时间、术后感染率、再骨折率、骨折前及末次随访时的Parker活动评分比较,组间差异均无统计学意义[WMD=3.87,95%CI(-1.95,9.70); WMD=-20.66,95%CI(-221.96,180.64); WMD=-2.95,95%CI(-7.16,1.25); RR=1.51,95%CI(0.57,3.98); RR=2.71,95%CI(0.72,10.15); WMD=-0.13,95%CI(-0.45,0.19); WMD=0.10,95%CI(-0.47,0.67)]; 与髓外固定组相比,髓内固定组的术中透视时间长[WMD=19.25,95%CI(8.75,29.75)]、再手术率低[RR=0.22,95%CI(0.09,0.55)]、内固定失败率低[RR=0.24,95%CI(0.10,0.56)]、骨折不愈合率低[RR=0.23,95%CI(0.07,0.81)]; 亚组分析显示,老年(平均年龄≥50岁)股骨转子下骨折患者采用髓内固定的内固定失败率和骨折不愈合率更低[RR=0.18,95%CI(0.07,0.47); RR=0.22,95%CI(0.06,0.86)]。结论:与髓外固定相比,采用髓内固定治疗股骨转子下骨折,内固定失败率、骨折不愈合率及再手术率较低,但术中透视时间较长。老年股骨转子下骨折患者更宜采用髓内固定治疗。
Abstract:
ABSTRACT Objective:To compare the curative effect and safety of intramedullary fixation versus extramedullary fixation for treatment of subtrochanteric fractures.Methods:All the randomized controlled trial(RCT)articles,controlled clinical trial(CCT)articles and retrospective trial articles about intramedullary fixation(intramedullary fixation group)versus extramedullary fixation(extramedullary fixation group)for treatment of subtrochanteric fractures that published at home and abroad included from September 1980 to September 2017 were retrieved from PubMed,The Cochrane Library,Embase,CBM,China national knowledge internet and WanFang Data through computer.The articles were screened and the information was extracted independently by two searchers.The methodological quality of research in the articles was evaluated according to Cochrane handbook and a Meta-analysis was conducted by using Revman 5.3 software.Results:Three thousand four hundred and ten articles were searched out.After screening,8 English articles(391 patients)were included in the final analysis,including 5 RCT articles,2 CCT articles and 1 retrospective trial article,225 patients in intramedullary fixation group and 166 patients in extramedullary fixation group.The results of Meta-analysis demonstrated that there was no statistical difference in operative time,intraoperative blood loss,hospital stay,postoperative

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备注/Memo

备注/Memo:
通讯作者:刘晋闽 E-mail:liujinmin19590501@icloud.com
更新日期/Last Update: 2018-07-02