Cui Xin, Liang Long, Zhang Hongyan, Li Yongyao, Cheng Hao, Liu Guangwei, Cheng Yongzhong, Du Yachao, Liu Jiani, Wang Zhibo, Tian Yaliang
Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing.
Guangzhou University of Traditional Chinese Medicine, Guangzhou.
Medicine (Baltimore). 2020 Feb;99(9):e19211. doi: 10.1097/MD.0000000000019211.
To assess the efficacy and safety of plaster splint vs splints in the treatment of distal radius fractures (DRFs).
For a more comprehensive collection of original study, we mainly searched 9 electronic databases including the PubMed, Web of Science, EMBASE, Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL), Clinical Trials.gov, the Chinese National Knowledge Infrastructure Database (CNKI), Wanfang Database, and VIP Database. The retrieval date of all databases is from the establishment to January 2019. In the aspect of assessing the quality of original research methodology, we mainly rely on the Cochrane risk bias assessment tool and GRADE assessment method. Revman 5.3 is used for statistical analysis.
A total of 8 studies involving 717 participants were included. The results showed that effective rate (RR = 0.99, 95%CI 0.91 to 1.07, P = .83), reduction rate (RR = 1.00, 95%CI 0.93 to 1.07, P = .98), and complication rate of the plaster splint had no significant difference with the splint. In addition, for the excellent rate of treatment, subgroup analysis based on the included studies found that when the intervention period was 4 weeks, the plaster splint was better than the splint, and when the intervention period was more than 4 weeks, there was no significant difference between them.
There is no sufficient evidence that plaster splint is superior to splint. However, according to current evidence, plaster splint is more effective than splint when the intervention period is shorter (4 weeks), and its advantage disappears when the intervention period is longer (> 4 weeks). It should be noted that the results of this study were influenced by the sample size and the quality of the included studies. More high-quality and well-controlled RCTs are needed to draw better conclusions in further study.
评估石膏夹板与普通夹板治疗桡骨远端骨折（DRF）的疗效及安全性。
为更全面地收集原始研究，我们主要检索了9个电子数据库，包括PubMed、Web of Science、EMBASE、Cochrane图书馆、Cochrane对照试验中心注册库（CENTRAL）、ClinicalTrials.gov、中国知网数据库（CNKI）、万方数据库和维普数据库。所有数据库的检索日期为建库至2019年1月。在评估原始研究方法的质量方面，我们主要依靠Cochrane偏倚风险评估工具和GRADE评估方法。使用Revman 5.3进行统计分析。
共纳入8项研究，涉及717名参与者。结果显示，石膏夹板的有效率（RR = 0.99，95%CI 0.91至1.07，P = 0.83）、复位率（RR = 1.00，95%CI 0.93至1.07，P = 0.98）和并发症发生率与普通夹板相比无显著差异。此外，对于治疗优良率，基于纳入研究的亚组分析发现，当干预期为4周时，石膏夹板优于普通夹板，当干预期超过4周时，两者无显著差异。
没有充分证据表明石膏夹板优于普通夹板。然而，根据目前的证据，当干预期较短（4周）时，石膏夹板比普通夹板更有效，而当干预期较长（>4周）时，其优势消失。需要注意的是，本研究结果受样本量和纳入研究质量的影响。进一步研究需要更多高质量、严格对照的随机对照试验以得出更好的结论。
