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儿童肱骨外髁骨折切开复位与闭合复位内固定的疗效比较:系统评价和荟萃分析。

Open versus closed reduction internal fixation for lateral condyle humeral fractures in children: a systematic review and meta-analysis.

机构信息

Department of Pediatrics, Suqian Hospital Affiliated to Xuzhou Medical University, Suqian, China.

Department of Pediatric Orthopedics, The First People's Hospital of Lianyungang, Lianyungang, 222000, Jiangsu Province, China.

出版信息

J Orthop Surg Res. 2023 Apr 26;18(1):322. doi: 10.1186/s13018-023-03808-3.

Abstract

OBJECTIVE

The objective of this meta-analysis was to illustrate the clinical outcomes and safety of two different management options for Song stage 2-4 lateral condyle humeral fractures in children.

METHOD

In January 2023, a systematic computer-based search was conducted. Data were retrieved for patients with two different management options for lateral condyle humeral fractures in children. The primary endpoints were clinical outcomes based on infection, avascular necrosis, and nonunion. After testing for publication bias and heterogeneity between studies, the data was aggregated for stochastic effect models when necessary.

RESULTS

Eight clinical studies with 742 patients were eventually included in the meta-analysis. There was no significant difference between the closed reduction and percutaneous pinning, and open reduction and internal fixation in terms of the clinical outcomes based on infection, avascular necrosis, and nonunion (P > 0.05).

CONCLUSIONS

Closed reduction and percutaneous pinning, as well as open reduction and internal fixation of lateral condyle humeral fractures in children, resulted in similar structural stability and functional outcomes. More high-quality randomized controlled trials are needed to determine this conclusion.

摘要

目的

本荟萃分析旨在展示儿童 Song 2-4 期外侧髁肱骨骨折两种不同治疗方案的临床结果和安全性。

方法

2023 年 1 月,进行了系统的计算机检索。检索了儿童外侧髁肱骨骨折两种不同治疗方案的患者数据。主要终点是基于感染、缺血性坏死和不愈合的临床结果。在对研究之间的发表偏倚和异质性进行检验后,必要时对随机效应模型进行了数据汇总。

结果

最终纳入了 8 项临床研究,共 742 例患者。闭合复位经皮克氏针固定与切开复位内固定在感染、缺血性坏死和不愈合方面的临床结果无显著差异(P>0.05)。

结论

儿童外侧髁肱骨骨折的闭合复位经皮克氏针固定与切开复位内固定均能获得相似的结构稳定性和功能结果。需要更多高质量的随机对照试验来确定这一结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1175/10131320/5a9052053257/13018_2023_3808_Fig1_HTML.jpg

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