Yang Z, Yuan Z Z, Ma J X, Ma X L
Department of Orthopedics, Tianjin Hospital, Tianjin 300000, China.
Zhonghua Yi Xue Za Zhi. 2016 Dec 20;96(47):3833-3837. doi: 10.3760/cma.j.issn.0376-2491.2016.47.014.
To make a systematic assessment of the complications of open reduction and internal fixation versus external fixation for unstable distal radius fractures. A computer-based online search of PubMed, ScienceDirect, EMBASE, BIOSIS, Springer and Cochrane Library were performed.The randomized and controlled trials of open reduction and internal fixation versus external fixation for unstable distal radius fractures were collected.The included trials were screened out strictly based on the criterion of inclusion and exclusion.The quality of included trials was evaluated.RevMan 5.0 was used for data analysis. A total of 17 studies involving 1 402 patients were included.There were 687 patients with open reduction and internal fixation and 715 with external fixation.The results of Meta-analysis indicated that there were statistically significant differences with regard to the postoperatively total complications, infection, malunion, tendon rupture (=8%, =0.77(95% 0.65-0.91, =3.10, <0.05). There were no statistically significant differences observed between two approaches with respect to nounion, re-operation, complex regional pain syndrome, carpal tunnel syndrome, neurapraxia, tendonitis, painful hardware, scar(>0.05). Postoperative complications are present in both open reduction and internal fixation and external fixation.Compared with external fixation, open reduction and internal fixation is lower in total complications postoperatively, infection and malunion, but external fixation has lower tendon rupture incidence.
对不稳定型桡骨远端骨折切开复位内固定与外固定的并发症进行系统评估。通过计算机在PubMed、ScienceDirect、EMBASE、BIOSIS、Springer和Cochrane图书馆进行在线检索。收集不稳定型桡骨远端骨折切开复位内固定与外固定的随机对照试验。严格根据纳入和排除标准筛选纳入的试验。评估纳入试验的质量。使用RevMan 5.0进行数据分析。共纳入17项研究，涉及1402例患者。切开复位内固定组687例，外固定组715例。Meta分析结果表明，术后总并发症、感染、畸形愈合、肌腱断裂方面存在统计学显著差异（=8%，=0.77(95% 0.65 - 0.91，=3.10，<0.05）。两种方法在不愈合、再次手术、复杂性区域疼痛综合征、腕管综合征、神经失用、肌腱炎、内固定物疼痛、瘢痕方面未观察到统计学显著差异（>0.05）。切开复位内固定和外固定术后均存在并发症。与外固定相比，切开复位内固定术后总并发症、感染和畸形愈合发生率较低，但外固定肌腱断裂发生率较低。
