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经皮撬拨复位固定与切开复位固定治疗中国患者移位跟骨骨折的系统评价与Meta分析

Percutaneous poking reduction and fixation versus open reduction and fixation in the treatment of displaced calcaneal fractures for Chinese patients: A systematic review and meta-analysis.

作者信息

Wang Xiao-Jian, Su Yun-Xing, Li Lu, Zhang Zhi-Hua, Wei Xiao-Chun, Wei Lei

机构信息

Department of Orthopaedic Surgery, Affiliated People's Hospital of Shanxi Medical University, Taiyuan 030012, China.

出版信息

Chin J Traumatol. 2016 Dec 1;19(6):362-367. doi: 10.1016/j.cjtee.2016.10.001.

Abstract

PURPOSE

To compare the efficacy of percutaneous poking reduction and fixationwith open reduction and fixation in the treatment of displaced calcaneal fractures.

METHODS

Reports of studies using case-controlled trials (CCT) to compare the percutaneous poking reduction and fixation with the open reduction and fixation in the management of calcaneal fractures were retrieved from the Cochrane Library, PubMed Database, CNKI, Chinese Biomedical Database, Wanfang Data (from January of 2005 to August of 2015). Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical software Revman 5.0 was used for data-analysis.

RESULTS

Fifteen articles were included in the meta-analysis. Comparison of the efficacy of percutaneous poking reduction and fixation with open reduction and fixation in the treatment of calcaneal fractures revealed statistical significance in the incidence of complications after operation [RR = 0.32, 95% CI (0.20, 0.5), p < 0.05]. However, there were neither statistical significance in the degrees of recovery for calcaneal Bohler angle [WMD = -1.65, 95% CI (-3.43, 0.14), p > 0.05] and calcaneal Gissane angle [WMD = -3.21, 95% CI (-6.75, 0.33), p > 0.05], nor statistical significance in the rate of good foot function after operation [RR= 0.95, 95% CI (0.90, 1.00), p > 0.05].

CONCLUSION

For the treatment of calcaneal fractures, percutaneous poking reduction and fixation is su- perior to open reduction and fixation in terms of the incidence of postoperative complications. But both techniques can obtain satisfactory clinical function.

摘要

目的

比较经皮撬拨复位固定与切开复位固定治疗移位跟骨骨折的疗效。

方法

从Cochrane图书馆、PubMed数据库、中国知网、中国生物医学数据库、万方数据(2005年1月至2015年8月)检索采用病例对照试验(CCT)比较经皮撬拨复位固定与切开复位固定治疗跟骨骨折的研究报告。对试验的方法学质量进行严格评估,并提取相关数据。使用统计软件Revman 5.0进行数据分析。

结果

15篇文章纳入荟萃分析。经皮撬拨复位固定与切开复位固定治疗跟骨骨折疗效比较,术后并发症发生率差异有统计学意义[RR = 0.32,95%CI(0.20,0.5),p < 0.05]。然而,跟骨Bohler角恢复程度[WMD = -1.65,95%CI(-3.43,0.14),p > 0.05]和跟骨Gissane角恢复程度[WMD = -3.21,95%CI(-6.75,0.33),p > 0.05]差异均无统计学意义,术后足部功能优良率差异也无统计学意义[RR = 0.95,95%CI(0.90,1.00),p > 0.05]。

结论

对于跟骨骨折的治疗,经皮撬拨复位固定在术后并发症发生率方面优于切开复位固定。但两种技术均可获得满意的临床功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb1d/5198923/2cbfac0441ea/gr1.jpg

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