Ma Dongmei, Huang Lei, Liu Bin, Liu Zhigang, Xu Xin, Liu Jianfeng, Chu Tianyue, Pan Liming
Department of Hand and Foot Surgery, The First Hospital of Jilin University, Changchun, China.
Front Surg. 2021 Jan 15;7:602053. doi: 10.3389/fsurg.2020.602053. eCollection 2020.
This study aims to compare the efficacy of the sinus tarsal approach (STA) with that of the conventional L-shaped lateral approach (CLSLA) in the treatment of calcaneal fractures by meta-analysis. PubMed, Embase, Web of Science, the Chinese National Knowledge Infrastructure, and China Wanfang database were searched to collect clinical randomized or non-randomized controlled trials of STA and CLSLA in the treatment of calcaneal fractures from January 2010 to May 2020. The data were analyzed by Stata 15.0 software. A total of 12 clinical trials were included, all of which were retrospective studies, including 961 patients. The results showed that when STA was compared with CLSLA, there was no difference in operation time with mean difference (MD) = -5.51 [95% confidence interval (CI): -12.57 to 1.55, > 0.05], less bleeding during operation with MD = -18.49 (95% CI:-23.79 to -13.18), no difference in Böhler angle after an operation with MD = 0.78 (95% CI: -0.09 to 1.65) and in Gissane angle with MD = -0.07 (95% CI: -1.90 to 1.77), no difference in American Orthopedic Foot and Ankle Society score with MD = 2.16 (95% CI: -1.07 to 5.38), higher-excellent and better rate of Maryland food function with relative ratio = 1.12 (95% CI: 1.04 to 1.20), and lower of incidence of postoperative complications with relative ratio = 0.23 (95% CI: 0.14-0.37). STA was more effective than CLSLA in the treatment of calcaneal fractures. Moreover, STA had advantages in less intraoperative bleeding, higher-excellent and better rate of Maryland foot function, lower incidence of postoperative complications, and higher safety.
本研究旨在通过荟萃分析比较跗窦入路（STA）与传统L形外侧入路（CLSLA）治疗跟骨骨折的疗效。检索了PubMed、Embase、Web of Science、中国知网和中国万方数据库，以收集2010年1月至2020年5月期间关于STA和CLSLA治疗跟骨骨折的临床随机或非随机对照试验。采用Stata 15.0软件对数据进行分析。共纳入12项临床试验，均为回顾性研究，包括961例患者。结果显示，与CLSLA相比，STA的手术时间差异无统计学意义，平均差（MD）=-5.51[95%置信区间（CI）：-12.57至1.55，P>0.05]；术中出血较少，MD=-18.49（95%CI：-23.79至-13.18）；术后Böhler角差异无统计学意义，MD=0.78（95%CI：-0.09至1.65），Gissane角差异无统计学意义，MD=-0.07（95%CI：-1.90至1.77）；美国矫形足踝协会评分差异无统计学意义，MD=2.16（95%CI：-1.07至5.38）；马里兰足部功能优良率较高，相对比=1.12（95%CI：1.04至1.20）；术后并发症发生率较低，相对比=0.23（95%CI：0.14 - 0.37）。在治疗跟骨骨折方面，STA比CLSLA更有效。此外，STA在减少术中出血、提高马里兰足部功能优良率、降低术后并发症发生率及提高安全性方面具有优势。
