Department of Orthopedic Trauma, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
J Coll Physicians Surg Pak. 2023 Jul;33(7):792-798. doi: 10.29271/jcpsp.2023.07.792.
This study aimed to compare the efficacy of cannulated screw combined with medial femoral plate and simple cannulated screw for Pauwels type III femoral neck fracture. In May 2022, relavent clinical trial articles were searched in seven online databases. After literature screening, quality evaluation, and data extraction according to the specific inclusion and exclusion criteria, the differences in therapeutic efficacy, complications, and intraoperative outcomes were compared between the two groups. A total of nine articles were finally included in the meta-analysis. The qualities of the nine articles were medium. Although the results showed that cannulated screw combined with medial femoral plate prolonged the operation time and increased blood loss (p <0.05), it demonstrated better fracture reduction and Harris score, shorter healing time and less internal fixation failure than in the simple cannulated screw in the treatment of Pauwels type III fracture (p <0.05). The sensitivity analysis, Egger's test, and trial sequential analysis (TSA) showed that the combination results were stable and reliable. This demonstrated that compared to that with the simple cannulated screw, the cannulated screw combined with medial femoral plate had better efficacy and less complication. Key Words: Femoral neck fracture, Therapy effect, Cannulated screw, Medial femoral plate, Trial sequential analysis.
本研究旨在比较空心螺钉联合内侧钢板与单纯空心螺钉治疗Ⅲ型 Pauwels 股骨颈骨折的疗效。2022 年 5 月，在七个在线数据库中检索相关临床试验文章。根据具体的纳入和排除标准进行文献筛选、质量评价和数据提取后，比较两组在治疗效果、并发症和术中结果方面的差异。最终共有 9 篇文章纳入荟萃分析。9 篇文章的质量为中等。虽然结果表明空心螺钉联合内侧钢板延长了手术时间并增加了出血量（p<0.05），但与单纯空心螺钉治疗 Pauwels Ⅲ型骨折相比，它显示出更好的骨折复位和 Harris 评分、更短的愈合时间和更少的内固定失败（p<0.05）。敏感性分析、Egger 检验和试验序贯分析（TSA）表明，联合结果稳定可靠。这表明与单纯空心螺钉相比，空心螺钉联合内侧钢板具有更好的疗效和更少的并发症。关键词：股骨颈骨折；治疗效果；空心螺钉；内侧钢板；试验序贯分析。
