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动力锁定钢板在治疗髋关节囊内骨折方面是否优于其他植入物：一项荟萃分析。

Is dynamic locking plate superior than other implants for intracapsular hip fracture: A meta-analysis.

作者信息

Li Tao, Zhang Qing-Song

机构信息

Department of Orthopedics, Puai Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China.

出版信息

Medicine (Baltimore). 2018 Nov;97(47):e13001. doi: 10.1097/MD.0000000000013001.

DOI:10.1097/MD.0000000000013001
PMID:30461606
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6392746/
Abstract

BACKGROUND

We studied the safety and efficacy of dynamic locking plate vs. other implants (cannulated cancellous screws [CCS] or sliding hip screw [SHS]) in patients undergoing intracapsular hip fracture (ICHF).

METHODS

We searched Pubmed, Embase, Web of Science, Cochrane library and Google database from inception to March 25, 2018. We selected any studies comparing dynamic locking plate for treatment ICHF. Non-union rate, osteonecrosis rate, cutout rate, revision rate, the replacement rate, and Harris hip scores were the outcomes. Stata 12.0 was used for meta-analysis.

RESULTS

Four studies involving 419 patients (143 patients in the dynamic locking plate group and 276 patients in the other implants group) were finally included. Compared with CCS or SHS, dynamic locking plate was associated with a reduction of nonunion rate, revision rate, replacement rate (P <.05). Furthermore, dynamic locking plate was also associated with an increase of the Harris hip scores (P <.05). There was no significant difference between the osteonecrosis rate and cutout rate (P >.05).

CONCLUSIONS

Current meta-analysis revealed that dynamic locking plate has a benefit role in improving postoperative clinical outcome than CCS or SHS in ICHF patients. Further high quality and large-scale randomized controlled trials (RCTs) are needed to further identify the efficacy of dynamic locking plate for ICHF.

摘要

背景

我们研究了动力锁定钢板与其他植入物（空心松质骨螺钉[CCS]或滑动髋螺钉[SHS]）在囊内髋部骨折（ICHF）患者中的安全性和有效性。

方法

我们检索了从数据库建立至2018年3月25日的PubMed、Embase、Web of Science、Cochrane图书馆和谷歌数据库。我们选择了任何比较动力锁定钢板治疗ICHF的研究。骨不连发生率、骨坏死发生率、穿出率、翻修率、置换率和Harris髋关节评分作为观察指标。使用Stata 12.0进行荟萃分析。

结果

最终纳入4项研究，共419例患者（动力锁定钢板组143例，其他植入物组276例）。与CCS或SHS相比，动力锁定钢板与骨不连发生率、翻修率、置换率降低相关（P<0.05）。此外，动力锁定钢板还与Harris髋关节评分增加相关（P<0.05）。骨坏死发生率和穿出率之间无显著差异（P>0.05）。

结论

目前的荟萃分析表明，在ICHF患者中，动力锁定钢板在改善术后临床结局方面比CCS或SHS具有优势作用。需要进一步开展高质量、大规模的随机对照试验（RCT）来进一步明确动力锁定钢板治疗ICHF的疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac43/6392746/e010ae4ff108/medi-97-e13001-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac43/6392746/7b90101755f9/medi-97-e13001-g001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac43/6392746/35e5dbd9f797/medi-97-e13001-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac43/6392746/e010ae4ff108/medi-97-e13001-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac43/6392746/7b90101755f9/medi-97-e13001-g001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac43/6392746/2b7c744bba8b/medi-97-e13001-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac43/6392746/03f1540216d7/medi-97-e13001-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac43/6392746/2469c72d82da/medi-97-e13001-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac43/6392746/35e5dbd9f797/medi-97-e13001-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac43/6392746/e010ae4ff108/medi-97-e13001-g010.jpg

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