摘要
目的系统评估经跗骨窦入路(STA)与传统外侧L形入路(ELA)治疗SandersⅡ、Ⅲ型跟骨骨折的疗效。方法计算机检索中国知网、维普、万方、中国生物医学文献数据库、Cochrane、PubMed和Embase等国内外医学数据库中有关STA和ELA治疗跟骨骨折的临床随机对照试验及临床病例对照研究的相关文献,检索年限设置为2010年1月至2021年12月。筛选符合标准的文献提取有效数据,使用RevMan 5.3软件对数据进行Meta分析。结果本研究共纳入10篇临床随机对照试验文献,共计676名患者(685足),其中STA组患者338例(343足),ELA组患者338例(342足)。Meta分析结果显示,STA组在手术时长(MD=-0.86,95%CI:-13.89~-3.31,P<0.01)、术中出血量(MD=-16.21,95%CI:-25.58~-6.84,P<0.01)、术后并发症(MD=0.22,95%CI:0.13~0.37,P<0.01)、住院时间(MD=-5.78,95%CI:-10.63~-0.93,P<0.05)、骨折愈合时间(MD=-1.37,95%CI:-2.19~-0.54,P<0.01)、Maryland评分优良率(MD=1.20,95%CI:1.08~1.34,P<0.01)方面优于ELA组,差异有统计学意义;在术后B9hler角(MD=0.19,95%CI:-0.44~0.82,P>0.05)及Gissane角(MD=0.93,95%CI:-0.20~2.07,P>0.05)差异无统计学意义。结论相较于ELA,STA治疗SandersⅡ、Ⅲ型跟骨骨折具有手术时间短、术中出血量及术后并发症少,骨折愈合时间及住院时间缩短等优势,且术后足部放射学方面评价与ELA无差异。
Objective To systematically evaluate the efficacy of sinus tarsi approach(STA)and conventional lateral extensile L-shape approach(ELA)in the treatment of Sanders type Ⅱ and Ⅲ calcaneal fractures.Methods The relevant literatures of randomized controlled trials(RCT)and clinical case-control trials(CCT)on the treatment of calcaneal fractures with STA and ELA were retrieved from domestic and foreign medical databases such as CNKI,VIP,WanFang,China Biomedical Literature Database(CBM),Cochrane,PubMed,Embase,etc.through computer.The retrieval time was set from January 2010 to December 2021.After screening the eligible literatures according to the inclusive criteria for valid data extraction,meta-analysis was perform using RevMan 5.3 software.Results Totally 10 RCT involving 676 patients were included,and there were 338 patients(343 feet)in STA group and 338 patients(342 feet)in ELA group.Meta-analysis results showed that STA group was superior to ELA group in terms of in operation time[MD=-0.86,95%CI(-13.31,-3.31),P<0.01],intraoperative bleeding[MD=-16.21,95%CI(-25.58,-6.84),P<0.01],postoperative complications[MD=0.22,95%CI(0.13,0.37),P<0.01],length of hospital stay[MD=-5.78,95%CI(-10.63,-0.93),P<0.05],fracture healing time[MD=-1.37,95%CI(-2.19,-0.54),P<0.01]and excellent and good rate of Maryland score[MD=1.20,95%CI(1.08,1.34),P<0.01].There was no significant difference in postoperative B9hler angle[MD=0.19,95%CI(-0.44,0.82),P>0.05]and Gissane angle[MD=0.93,95%CI(-0.20,2.07),P>0.05]between two groups.Conclusion In the treatment of Sanders type Ⅱ and Ⅲ calcaneal fractures,STA has the advantages of shorter operation time,less intraoperative blood loss and postoperative complications and shorter fracture healing time and hospital stay compared with ELA,and there is no statistical difference in postoperative radiological evaluation of the foot.
作者
杨博
韩树峰
郝耀
YANG Bo;HAN Shu-feng;HAO Yao(The First School of Clinical Medicine of Shanxi Medical University,Taiyuan,Shanxi 030001,China;不详)
出处
《中国临床研究》
CAS
2022年第12期1699-1705,共7页
Chinese Journal of Clinical Research
基金
山西省留学人员科技活动择优资助项目(20200037)。
关键词
跟骨骨折
关节内骨折
跗骨窦入路
传统外侧L形入路
切开复位内固定
Calcaneal fractures
Intra-articular fractures
Sinus tarsi approach
Extensile lateral approach
Open reduction internal fixation
