用于髋部骨折的短髓内装置还是长髓内装置？证据的系统评价
Short or long intramedullary devices for hip fracture? A systematic review of the evidence.
作者信息
Page Piers R J, Poole William E C, Shah Kanishk, Upadhyay Piyush K
机构信息
Frimley Health NHS Foundation Trust, United Kingdom.
Brighton and Sussex University Hospitals NHS Trust, United Kingdom.
出版信息
J Orthop. 2020 Aug 29;22:377-382. doi: 10.1016/j.jor.2020.08.030. eCollection 2020 Nov-Dec.
Abstract
Trochanteric hip fractures may be fixed with either sliding hip screws or intramedullary devices. Current UK guidance is that intramedullary fixation should be used for AO/OTA 31A3 fractures but does not stipulate length of nail. We present a systematic review comparing short and long nails for these injuries in older patients. Three studies were randomized, all with methodological concerns. None demonstrated a clinically significant difference in outcome. There is no good evidence to support long over short intramedullary devices in this scenario. Evidence is required to demonstrate whether the potentially increased surgical risk confers any benefits in this group.
摘要
股骨转子间髋部骨折可用滑动髋螺钉或髓内装置固定。英国目前的指南指出，AO/OTA 31A3型骨折应采用髓内固定，但未规定髓内钉的长度。我们进行了一项系统评价，比较老年患者此类损伤使用短髓内钉和长髓内钉的情况。三项研究为随机对照研究，均存在方法学问题。没有一项研究显示在临床结局上有显著差异。在这种情况下，没有充分证据支持使用长髓内装置优于短髓内装置。需要证据来证明在该组患者中，潜在增加的手术风险是否能带来任何益处。
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