[1]钟义 李峰△ 胡铮潮 李琳.不同内固定方式治疗股骨颈骨折的网状Meta分析[J].中国中医骨伤科杂志,2020,28(02):43-48.
　ZHONG Yi LI Feng HU Zhengchao LI Lin.Different Internal Fixation of Femoral Neck Fractures:A Network Meta-analysis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2020,28(02):43-48.
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不同内固定方式治疗股骨颈骨折的网状Meta分析()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第28卷
期数:
2020年02期
页码:
43-48
栏目:
文献研究
出版日期:
2020-02-10

文章信息/Info

Title:
Different Internal Fixation of Femoral Neck Fractures:A Network Meta-analysis
文章编号:
1005-0205(2020)02-0043-06
作者:
钟义1 李峰1△ 胡铮潮1 李琳2
1湖北中医药大学针灸骨伤学院(武汉,430065)2湖北省中医院(光谷院区)骨伤科
Author(s):
ZHONG Yi1 LI Feng1△ HU Zhengchao1 LI Lin2
1College of Acupuncture and Orthopedics,Hubei University of Chinese Medicine,Wuhan 430065,China; 2Department of Orthopaedic,Hubei Provincial Hospital of Traditional Chinese Medicine,Wuhan 430074,China.
关键词:
股骨颈骨折;  空心螺钉;  支撑钢板;  股骨近端锁定板;  Meta分析
Keywords:
femoral neck fractures;  pauwels angle;  cannulated screws;  buttress plate;  proximal femoral plate;  Meta-analysis
分类号:
R687.3
文献标志码:
A
摘要:
目的:应用网状Meta分析评价不同内固定方式治疗股骨颈骨折的临床疗效。方法:通过计算机检索EMbase,PubMed,Cochrane图书馆,CBM,中国知网,万方数据库,维普数据库,搜集不同内固定方式治疗Pauwels Ⅱ,Ⅲ型股骨颈骨折的临床随机对照试验。依照 Cochrane 风险偏移评估工具,安排两名研究者独立完成数据提取与评估,采用 Stata14.0和GeMTC0.14.3软件进行数据分析。结果:最终纳入 8篇文献,共研究479髋。其中采用空心螺钉内固定235髋,空心螺钉联合内侧支撑钢板内固定175髋,股骨近端锁定板69髋。网状 Meta 分析结果显示,采用股骨近端锁定板在术后发生股骨头坏死的风险低于空心螺钉联合内侧支撑钢板及空心螺钉,而在术后骨折不愈合的风险上空心螺钉联合内侧支撑钢板发生的可能最低,同时,从术后6个月Harris评分来看,空心螺钉联合内侧钢板的排名显著高于其他两种内固定方式。结论:3 种不同内固定方式在治疗Pauwels Ⅱ,Ⅲ型股骨颈骨折方面,采用空心螺钉联合内侧钢板内固定的临床疗效总体表现优于股骨近端锁定板和空心螺钉内固定,可能是临床上治疗Pauwels Ⅱ,Ⅲ型股骨颈骨折最优的内固定选择。
Abstract:
Objective:To evaluate the clinical efficacy of different internal fixation methods in the treatment of femoral neck fracture by network meta-analysis.Methods:EMbase,PubMed,Cochrane Library,CBM,CNKI,WanFang,CBM and VIP were searched by computer to retrieve randomized controlled trials of three kinds of internal fixation schemes for the treatment of Pauwels Ⅱ and Ⅲ femoral neck fractures.According to Cochrane risk migration assessment tool,two researchers were arranged to complete data extraction and evaluation independently.Stata 14.0 and GeMTC0.14.3 software were used for data analysis.Results:A total of Eight literatures involving 479 hips were included.Among them,235 hips were fixed with hollow screw,175 hips were fixed with hollow nail combined with inner supporting plate,and 69 hips were fixed with proximal femoral locking plate.The results of network meta-analysis showed that the risk of femoral head necrosis with proximal femoral locking plate was lower than that with hollow screw combined with inner supporting plate and hollow screw.Hollow screw combined with inner supporting plate have the lowest risk of nonunion of fracture after operation.Meanwhile,Harris score at the 6th month after operation of hollow screw combined with inner supporting plate was significantly higher than others.Conclusion:In the treatment of Pauwels Ⅱ and Ⅲ femoral neck fractures,hollow screw combined with inner supporting plate internal fixation has better overall performance than proximal femoral locking plate and hollow screw,which may be the best choice for clinical treatment of Pauwels Ⅱ and Ⅲ femoral neck fractures.

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备注/Memo

备注/Memo:
基金项目:湖北省自然科学基金资助项目(2011CDC032)△通信作者 E-mail:690683196@qq.com(收稿日期:2019-09-05)
更新日期/Last Update: 2020-02-10