摘要
目的:系统评价钩钢板内固定、带袢钢板内固定和韧带重建术这3种手术方法治疗肩锁关节脱位的临床疗效。方法:应用计算机检索中国知网、维普网、万方数据库、中国生物医学文献服务系统、PubMed、Embase和Cochrane Library中关于手术方法治疗RockwoodⅢ型及以上肩锁关节脱位的对比研究文献,检索时限均为建库至2024年1月1日。试验组采用钩钢板内固定、带袢钢板内固定或韧带重建术,对照组采用与试验组不同的上述3种手术方法中的1种。依据文献检索及筛选方案筛选出符合要求的文献后,由2名研究人员分别独立进行数据提取和质量评价。采用Stata14.0软件对手术时间、住院时间、术后3个月Constant-Murley肩关节评分、术后1年Constant-Murley肩关节评分、术后再次脱位发生率进行网状Meta分析,并根据累计概率排名曲线下面积(the surface under the cumulative ranking curve, SUCRA)进行排序。采用漏斗图检验发表偏倚。结果:共检索到1371篇文献,最终纳入17篇文献。手术时间排序为韧带重建术(SUCRA=89.5%)>带袢钢板内固定(SUCRA=59.6%)>钩钢板内固定(SUCRA=0.9%);住院时间排序为钩钢板内固定(SUCRA=94.8%)>带袢钢板内固定(SUCRA=49.6%)>韧带重建术(SUCRA=5.6%);术后3个月Constant-Murley肩关节评分排序为韧带重建术(SUCRA=99.3%)>带袢钢板内固定(SUCRA=50.6%)>钩钢板内固定(SUCRA=0.1%);术后1年Constant-Murley肩关节评分排序为韧带重建术(SUCRA=79.3%)>带袢钢板内固定(SUCRA=69.2%)>钩钢板内固定(SUCRA=1.5%);术后再次脱位发生率排序为韧带重建术(SUCRA=97.5%)>钩钢板内固定(SUCRA=45.9%)>带袢钢板内固定(SUCRA=6.6%)。结论:现有证据表明,采用手术方法治疗RockwoodⅢ型及以上肩锁关节脱位,钩钢板内固定在缩短手术时间方面更具优势,韧带重建术在缩短住院时间、缓解疼痛及恢复肩关节功能等方面更具优势,带袢钢板内固定在预防术后再次�
Objective:To systematically review the clinical efficacy of hook plate internal fixation,loop plate internal fixation and ligament reconstruction in treatment of acromioclavicular joint dislocation(ACJD).Methods:All the comparative study articles about surgical procedure for treatment of Rockwood typeⅢand above ACJD included from database's inception to January 1,2024 were retrieved from the China National Knowledge Infrastructure,Vip Database,Wanfang Database,Chinese Biomedical Literature Service System,PubMed,Embase,and Cochrane Library through computer.The patients in experiment group were treated with hook plate internal fixation,loop plate internal fixation or ligament reconstruction,while the ones in control group with one of the above three surgical methods differing from the one used in experiment group.The eligible articles were screened according to the retrieval and screening scheme.The information was extracted and the methodological quality of the included researches in the articles was evaluated independently by two researchers,and then a reticulated Meta-analysis on operative time,hospital stays,Constant-Murley shoulder scores measured at 3 and 12 months after the surgery,and postsurgical redislocation incidence rate was conducted by using Stata14.0 software,furthermore,the efficacies of the adopted surgical methods were ranked according to the surface under the cumulative ranking curve(SUCRA),and the publication bias was tested by using funnel plots.Results:One thousand three hundred and seventy-one articles were searched out.After screening,17 articles were included in the final analysis.The results of reticulated Meta-analysis showed that,in treatment of ACJD,the ligament reconstruction(SUCRA=89.5%)behaved best in operative time,followed by loop plate internal fixation(SUCRA=59.6%)and hook plate internal fixation(SUCRA=0.9%);and the hook plate internal fixation(SUCRA=94.8%)behaved best in hospital stays,followed by loop plate internal fixation(SUCRA=49.6%)and ligament reconstruction(SUCRA=5.6%
作者
张志猛
袁道通
王旭
谢文鹏
张永奎
ZHANG Zhimeng;YUAN Daotong;WANG Xu;XIE Wenpeng;ZHANG Yongkui(The First Clinical Medical Collge of Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong,China;Jinan Municipal Hospital of Traditional Chinese Medicine,Jinan 250012,Shandong,China;The Affliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong,China)
出处
《中医正骨》
2024年第10期25-31,56,共8页
The Journal of Traditional Chinese Orthopedics and Traumatology
关键词
肩锁关节
脱位
骨折固定术
内
韧带重建
网络Meta分析
acromioclavicular joint
dis loc ations
fracture fixation,internal
ligament reconst ruction
network Meta-analysis
