Department 8, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, 400042, People's Republic of China.
Int Orthop. 2013 Aug;37(8):1495-500. doi: 10.1007/s00264-013-1871-z. Epub 2013 May 5.
The purpose of this study was to assess the effects of operative and non-operative treatment on clavicle fractures.
Relevant clinical trials on the operative and non-operative treatment for clavicle fractures were retrieved through searching the databases MEDLINE, Embase, OVID and the Cochrane Central Register of Controlled Trials up to December 2011. The quality of the included studies was assessed by two authors. A meta-analysis was carried out on homogeneous studies. Five studies involving 633 clavicle fractures were included.
The differences in nonunion [risk ratio (RR) 0.12, 95 % confidence interval (CI) 0.05-0.29], malunion (RR 0.11, 95 % CI 0.04-0.29) and neurological complications (RR 0.45, 95 % CI 0.25-0.81) were statistically significant between operative and non-operative treatment. There was no statistically significant difference in delayed union (RR 0.78, 95 % CI 0.31-1.95).
Operative treatment is better than non-operative treatment, but decisions should be made in accordance with specific conditions for clinical application.
本研究旨在评估手术和非手术治疗对锁骨骨折的影响。
通过检索 MEDLINE、Embase、OVID 和 Cochrane 对照试验中心数据库，检索截至 2011 年 12 月的手术和非手术治疗锁骨骨折的相关临床试验。由两位作者评估纳入研究的质量。对同质研究进行荟萃分析。纳入了 5 项涉及 633 例锁骨骨折的研究。
手术与非手术治疗在骨折不愈合[风险比（RR）0.12，95 %置信区间（CI）0.05-0.29]、畸形愈合（RR 0.11，95 % CI 0.04-0.29）和神经并发症（RR 0.45，95 % CI 0.25-0.81）方面的差异有统计学意义。但在延迟愈合（RR 0.78，95 % CI 0.31-1.95）方面差异无统计学意义。
手术治疗优于非手术治疗，但临床应用时应根据具体情况作出决策。
