摘要
[目的]对比髓内钉治疗胫骨干骨折采用髌上入路与髌下入路的疗效与术后并发症差异。[方法]检索7个国内外数据库,经过文献筛选和数据提取后进行Meta分析。[结果]共纳入11项随机对照试验。结果显示两种入路的手术时间相当(P>0.05),术中出血量相当(P>0.05),住院时间相当(P>0.05),骨折愈合时间相当(P>0.05)。然而髌上入路的术后膝疼痛发生率小于髌下入路(P<0.05),髌上入路的术后远期Lysholm膝关节评分高于髌下入路(P<0.05),髌上入路的术后远期HSS高于髌下入路(P<0.05)。[结论]髓内钉治疗胫骨干骨折采用髌上入路与髌下入路的手术时间、术中出血量、住院时间和骨折愈合时间差异无统计学意义,但髌上入路的术后膝疼痛发生率较小,术后膝关节功能恢复情况较好。然而,上述结论仍需要设计更加完善的高质量随机对照试验证实。
[Objective] To compare the postoperative complications and the clinical outcomes of the suprapatellar approach versus transpatellar approach for intramedullary nailing in the treatment of tibial shaft fracture.[Methods] Seven domestic and foreign databases were searched. Meta-analysis was carried out after literature screening and data extraction.[Results] A total of 11 randomized controlled trials were included into this study. As results of the meta-analysis, the two operative approaches was comparable in the operation time(P>0.05), intraoperative blood loss(P>0.05), the hospital stay(P>0.05), and the fracture healing time(P>0.05), however, the suprapatellar approach group had significantly lower incidence of postoperative knee pain(P<0.05), whereas significantly higher long-term Lysholm knee score(P<0.05) and higher long-term HHS(P<0.05) than the transpatellar approach.[Conclusions] Although there is no significant difference between the two approaches in the operation time, intraoperative blood loss, hospital stay and fracture healing time, the suprapatellar approach is significantly superior to the transpatellar approach in incidence of postoperative knee pain and knee function recovery. However, more comprehensive highquality randomized controlled trials are needed to confirm the above conclusion.
作者
张驰
章晓云
祁文
韩杰
林宗汉
陈跃平
刘建航
吴晓飞
张磊
ZHANG Chi;ZHANG Xiao-yun;QI Wen;HAN Jie;LIN Zong-han;CHEN Yue-ping;LIU Jian-hang;WU Xiao-fei;ZHANG Lei(Postgraduate College,Guangxi University of Chinese Medicine,Nanning 530001,China;Department of Orthopedics,Ruikang Hospital,Guangxi University of Chinese Medicine,Nanning 530011,China;Guangxi University of Chinese Medicine,Nanning 530001,China;Department of Orthopedic Manipulation,Ruikang Hospital,Guangxi University of Chinese Medicine,Nanning 530011,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2019年第20期1882-1886,共5页
Orthopedic Journal of China
基金
国家自然科学基金资助项目（编号：81760796）
2017年广西中医药大学校级培育学科-骨外科学建设项目（编号：04B2017082）
中医药发展规划十大工程项目（部门预算社（2018）1号）
岐黄工程高层次人才团队培育项目（编号：2018004）
关键词
髓内钉
胫骨干骨折
髌上入路
髌下入路
Meta分析
intramedullary nail
tibial shaft fracture
suprapatellar approach
transpatellar approach
metaanalysis
