摘要
目的应用Meta分析的方法评价切开复位内固定（ORIF）与闭合复位内固定（CRIF）治疗移位型儿童股骨颈骨折疗效的差异。方法计算机检索Cochrane图书馆、PubMed、CNKI中国期刊全文数据库、中国生物医学文献数据库、万方数据库以及维普数据库，并辅以手工检索本专业相关杂志。检索时间为建库至2017年8月，收集ORIF与CRIF治疗移位型儿童股骨颈骨折的文献，严格评价文献质量及提取相关资料。运用Revman5．0软件统计并分析数据，评估其相对危险度（RR）和95％可信区间（CI）。结果共纳入10篇ORIF与CRIF治疗移位型儿童股骨颈骨折疗效比较的文献，共309例患儿，其中163例患儿行ORIF术，146例行CRIF术。ORIF组术后骨折解剖复位率[RR=0．33，95％CI（O．22，0．49），P〈0．05]和关节功能Ratliff评定优良率[RR=0．73，95％CI（O．62，0．85），P〈0．05]均高于CRIF组，差异有统计学意义。ORIF组术后股骨头缺血性坏死的发生率[RR=1．93，95％ci（1．13，3．31），P〈0．05]、髋内翻发生率[RR=2．38，95％CI（1．07，5．27），P〈0．05]以及骨折不愈合率[RR=2．72，95％CI（1．05，7．04），P〈0．05]均低于CRIF组，差异有统计学意义。结论与CRIF比较，ORIF治疗移位型儿童股骨颈骨折临床效果较好，并发症较少，术后关节功能优良率较高，故ORIF治疗移位型儿童股骨颈骨折是值得推荐的方法。
Objective To compare open reduction and internal fixation （ORIF） with closed re- duction and internal fixation （CRIF） for the treatment of displaced fractures of the femoral neck in children, using a Meta-analysis. Methods Cochrane Library, PubMed Data, CNKI, Chinese Biomedical Database, Wanfang Data and Vip Data were searched for studies on treating displaced fractures of the femoral neck in children with ORIF and CRIF. In addition, hand search was conducted in relevant journals. Time limit for search was set from the beginning till August 2017. After eligible studies were included, a database was established of the demographic and clinical data of the patients included. Software Revman 5.0 was used for heterogeneity test of the quality of the studies included and the pooled relative risk （RR） and 95% con- fidence interval （CI） were calculated. Results Ten studies were ultimately included involving 309 pa- tients. Of them, 163 were treated by ORIF and 146 by CRIF. The results showed that ORIF led to a sig- nificantly higher rate of anatomical reduction [ RR =0.33, 95% C1 （0.22, O. 49）, P 〈 0. 05] and a sig- nificantly higher good to excellent rate by Ratliffs evaluation [ RR = 0.73, 95% CI （0. 62, O. 85）, P 〈 0. 05] than CRIF did; ORIF also led to a significantly lower rate of avascular necrosis[ RR = 1.93, 95% CI （1. 13, 3.31）, P 〈 0. 05], a significantly lower rate of coxa vara [ RR =2.38, 95% CI （1.07, 5.27）, P 〈 0.05 ] and a significantly lower rate of nonunion [ RR = 2.72, 95% CI （ 1.05, 7.04）, P 〈 0. 05 ] than CRIF did. Conclusion In the treatment of displaced fractures of the femoral neck in children, ORIF can lead to better reduction, fewer complications and a higher good to excellent rate of functional recovery than CRIF.
作者
田守进
朱贤
缪健荣
周志平
Tian Shoujin;Zhu Xian;Miao Jianrong;Zhou Zhiping(Department of Orthopaedic Surgery,The First People＇s Hospital of Zhangiiagang,Soochow University,Zhangfiagang 215600,Jiangsu,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2018年第7期560-565,共6页
Chinese Journal of Orthopaedic Trauma
关键词
股骨颈骨折
骨折固定术
内
儿童
系统评价
Femoral neck fractures
Fracture fixation
internal
Child
Systematic andysis
