Gansu Provincial Hospital, 204 Donggang West Road, Chengguan District, Lanzhou, 730000, China.
Institution of Clinical Research and Evidence-Based Medicine, The Gansu Provincial Hospital, Lanzhou, China.
J Orthop Surg Res. 2021 Nov 22;16(1):687. doi: 10.1186/s13018-021-02806-7.
To compare the effects between computer-assisted and traditional cannulated screw internal fixation on treating femoral neck fracture.
The search was conducted in Embase, Pubmed, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang Database from the beginning to August 2020. RevMan5.4 software, which was provided by the International Cochrane Group, was used for the meta-analysis comparing the differences in operation time, intraoperative bleeding volume, fluoroscopy frequency, fracture healing time, total drilling times, Harris score, fracture healing rate, and femoral head necrosis rate between computer-assisted and traditional methods groups.
A total of 1028 patients were included in 16 studies. Primary outcome indicators: Compared with the traditional method group, the computer-assisted group had less operative time (2RCTs, P < 0.00001; 8 non-RCTs, P = 0.009; Overall, P < 0.00001), intraoperative bleeding (1 RCTs, P < 0.00001; 9non-RCTs, P < 0.00001; Overall, P < 0.00001), femoral head necrosis rate (1 RCT, P = 0.11;7 non-RCTs, P = 0.09; Overall, P = 0.02) and higher Harris scores (1 RCT, P < 0.0001; 9 non-RCTs, P = 0.0002; Overall, P < 0.0001), and there were no significant differences in fracture healing rate between the two groups (5 non-RCTs, P = 0.17). Secondary outcomes indicators: The computer-assisted group had a lower frequency of intraoperative fluoroscopy and total number of drills compared with the traditional method group, while there was no significant difference in fracture healing time.
Compared with the traditional hollow screw internal fixation on the treatment of femoral neck fracture, computer-assisted percutaneous cannulated screw fixation can shorten the operation time and improve the operation efficiency and reduce the X-ray injury of medical staff and help patients obtain a better prognosis. Therefore, computer-assisted percutaneous cannulated screw fixation is a better choice for the treatment of femoral neck fracture. Study registration PROSPERO registration number CRD42020214493.
比较计算机辅助与传统空心钉内固定治疗股骨颈骨折的效果。
检索 Embase、Pubmed、Web of Science、Cochrane Library、中国知网（CNKI）和万方数据库，检索时限均为建库至 2020 年 8 月。采用国际 Cochrane 协作网提供的 RevMan5.4 软件进行荟萃分析，比较计算机辅助组与传统方法组在手术时间、术中出血量、透视次数、骨折愈合时间、总钻孔次数、Harris 评分、骨折愈合率和股骨头坏死率方面的差异。
共纳入 16 项研究的 1028 例患者。主要结局指标：与传统方法组相比，计算机辅助组手术时间更短（2 项 RCTs，P＜0.00001；8 项非 RCTs，P＝0.009；总体，P＜0.00001）、术中出血量更少（1 项 RCT，P＜0.00001；9 项非 RCTs，P＜0.00001；总体，P＜0.00001）、股骨头坏死率更低（1 项 RCT，P＝0.11；7 项非 RCTs，P＝0.09；总体，P＝0.02）、Harris 评分更高（1 项 RCT，P＜0.0001；9 项非 RCTs，P＝0.0002；总体，P＜0.0001），两组骨折愈合率无显著差异（5 项非 RCTs，P＝0.17）。次要结局指标：计算机辅助组术中透视次数和总钻孔次数均低于传统方法组，而骨折愈合时间无显著差异。
与传统空心螺钉内固定治疗股骨颈骨折相比，计算机辅助经皮空心钉固定可缩短手术时间，提高手术效率，减少医务人员的 X 射线损伤，有助于患者获得更好的预后。因此，计算机辅助经皮空心钉固定是治疗股骨颈骨折的更好选择。研究注册 PROSPERO 注册号 CRD42020214493。
