Li Ning, Chen Shaoying
Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,
Eur J Orthop Surg Traumatol. 2014 Aug;24(6):851-5. doi: 10.1007/s00590-013-1367-y. Epub 2013 Nov 20.
The purpose of this study was to demonstrate whether open reduction and internal-fixation (ORIF) was superior to radial head replacement in treatment of Mason type III radial head fractures by comparing postoperative complication rate and satisfactory rate.
Clinical trials comparing ORIF with radial head replacement for Mason type III radial head fractures were reviewed published up to September 1, 2012. Methodological quality of each included trials was assessed using the Jadad scale. The analyses were performed with Cochrane RevMan software version 5.1.
One prospective randomized controlled trial and one comparative study involving 67 patients with 67 cases were included in this systematic review and meta-analysis. Both the forest plots of complication rate and satisfactory rate indicated statistical differences between the two surgical techniques in treatment of Mason type III radial head fractures. The complication rate was 13.9 % in patients treated with radial head replacement and 58.1 % in patients treated with ORIF. The satisfactory rate was 91.7 % in patients treated with radial head replacement and 51.6 % in patients treated with ORIF.
Given the available evidence, radial head replacement appeared to reach better outcomes in patients with Mason type III radial head fractures followed 5 years or less.
Therapeutic II.
本研究旨在通过比较术后并发症发生率和满意率，证明切开复位内固定术（ORIF）在治疗Mason III型桡骨头骨折方面是否优于桡骨头置换术。
检索截至2012年9月1日发表的比较ORIF与桡骨头置换术治疗Mason III型桡骨头骨折的临床试验。使用Jadad量表评估每个纳入试验的方法学质量。采用Cochrane RevMan 5.1软件进行分析。
本系统评价和荟萃分析纳入了1项前瞻性随机对照试验和1项涉及67例患者67例病例的比较研究。并发症发生率和满意率的森林图均显示，两种手术技术在治疗Mason III型桡骨头骨折方面存在统计学差异。桡骨头置换术治疗患者的并发症发生率为13.9%，ORIF治疗患者的并发症发生率为58.1%。桡骨头置换术治疗患者的满意率为91.7%，ORIF治疗患者的满意率为51.6%。
根据现有证据，桡骨头置换术似乎在随访5年及以内的Mason III型桡骨头骨折患者中能取得更好的疗效。
治疗性II级。
