Department of Orthopaedics, No.1 Hospital of China Medical University, Shenyang, China.
Department of Orthopaedics, Shenyang Orthopaedic Hospital, Shenyang, China.
J Orthop Surg Res. 2020 Sep 3;15(1):377. doi: 10.1186/s13018-020-01904-2.
The aim of this study is to assess the prevalence of nonunion in patients with tibia fracture and the association between influencing factors and tibia fracture nonunion.
A database searches of PubMed, the Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Weipu database, and Wanfang database from inception until June 2019 was conducted. The pooled prevalence, odds ratio (OR), and 95% confidence intervals (CI) were calculated with Stata software.
In this study, 111 studies involving 41,429 subjects were included. In the study of the relationship between influencing factors and tibia fracture nonunion, 15 factors significantly influenced the fracture union, including > 60 years old, male, tobacco smoker, body mass index > 40, diabetes, nonsteroidal anti-inflammatory drugs (NSAIDs) user, opioids user, fracture of middle and distal tibia, high-energy fracture, open fracture, Gustilo-Anderson grade IIIB or IIIC, Müller AO Classification of Fractures C, open reduction, fixation model, and infection.
The prevalence of nonunion in patients with tibia fracture was 0.068 and 15 potential factors were associated with the prevalence. Closed reduction and minimally invasive percutaneous plate osteosynthesis (MIPPO) have the low risks of nonunion for the treatment of tibial fractures.
本研究旨在评估胫骨骨折患者骨不连的发生率，并探讨影响因素与胫骨骨折不连的相关性。
检索 PubMed、Cochrane 图书馆、EMBASE、中国知网（CNKI）、维普数据库和万方数据库，检索时限均从建库至 2019 年 6 月。采用 Stata 软件计算汇总发生率、比值比（OR）及其 95%置信区间（CI）。
本研究共纳入 111 项研究，涉及 41429 例患者。在影响因素与胫骨骨折不连关系的研究中，有 15 个因素显著影响骨折愈合，包括年龄>60 岁、男性、吸烟者、体质量指数>40、糖尿病、非甾体抗炎药（NSAIDs）使用者、阿片类药物使用者、中下段胫骨骨折、高能损伤、开放性骨折、Gustilo-Anderson Ⅲ B 或Ⅲ C 型、Müller AO 骨折分型 C、切开复位、固定方式和感染。
胫骨骨折患者骨不连的发生率为 0.068，有 15 个潜在因素与发生率相关。闭合复位和微创经皮钢板固定术（MIPPO）治疗胫骨骨折的不连风险较低。
