Institute of Traumatology and Orthopaedics, 920th Hospital of Joint Logistics Support Force, PLA, Kunming, China.
J Orthop Surg Res. 2021 May 8;16(1):304. doi: 10.1186/s13018-021-02448-9.
This systematic review was conducted to gather available evidence on the effectiveness of muscle pedicle bone flap transplantation in adult patients with femoral neck fractures.
Databases such as PubMed, EMBASE, IEEE, Web of Science, and Cochrane library were searched from their dates of inception until March 2021. Two reviewers independently selected the interventional studies on the assessment of the effectiveness of muscle pedicle bone flap transplantation for femoral neck fractures; data extraction and assessment of the methodological quality as per the Institute of Health Economics quality appraisal checklist were also performed by the reviewers. The effectiveness and complication outcomes were assessed by calculating the average rates.
Overall, 20 studies with 1022 patients were included in this review. Notably, the methodologic quality of the included studies was typically poor. The average effective rates were as follows: good, 73.4%; fair, 15.4%; and poor, 10.9%. Moreover, the average nonunion rate, average avascular necrosis rate, average collapse rate, and the overall reoperation rate were 9.0%, 6.7%, 4.7%, and 7.3%, respectively.
This systematic review of heterogeneous studies with varying number of patients and varying surgical techniques indicated that muscle pedicle bone flap transplantation provides promising results with low rates of avascular necrosis and nonunion. Nevertheless, further controlled studies are required to ascertain the effectiveness of muscle pedicle bone flap transplantation in treating femoral neck fracture.
本系统评价旨在收集关于带血管蒂骨瓣移植治疗成人股骨颈骨折疗效的现有证据。
检索 PubMed、EMBASE、IEEE、Web of Science 和 Cochrane 图书馆等数据库，检索时间从建库至 2021 年 3 月。两位评价员独立筛选评估带血管蒂骨瓣移植治疗股骨颈骨折疗效的干预性研究；按照卫生经济研究所质量评价清单对纳入研究的方法学质量进行评估，并提取数据。采用计算平均率的方法评估疗效和并发症结局。
共纳入 20 项研究，总计 1022 例患者。纳入研究的方法学质量通常较差。优良率、中率和差率的平均有效率分别为 73.4%、15.4%和 10.9%。此外，非愈合率、骨坏死率、塌陷率和总再手术率的平均率分别为 9.0%、6.7%、4.7%和 7.3%。
纳入的研究数量和手术技术各不相同，具有异质性，本系统评价结果表明，带血管蒂骨瓣移植治疗股骨颈骨折疗效较好，骨坏死和非愈合发生率较低。然而，仍需要进一步的对照研究来确定带血管蒂骨瓣移植治疗股骨颈骨折的疗效。
