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儿童肱骨外侧髁骨折闭合复位经皮穿针与切开复位穿针固定的荟萃分析。

A meta-analysis of closed reduction percutaneous pinning and open reduction with pin fixation of pediatric humeral lateral condylar fracture.

作者信息

Meng Chao, Meng Zhen, Huang Xin, Zhao Fenghua, Yang Qun

机构信息

Department of Pediatric Surgery, The Affiliated Tengzhou Central People's Hospital of Xuzhou Medical University, Tengzhou, China.

Department of Quality Control, Tengzhou Hospital of Traditional Chinese Medicine, Tengzhou, China.

出版信息

Front Pediatr. 2023 Jun 30;11:1205755. doi: 10.3389/fped.2023.1205755. eCollection 2023.

Abstract

OBJECTIVE

To compare the effectiveness and safety of closed reduction percutaneous pinning vs. open reduction with pin fixation to treat the pediatric humeral lateral condylar fracture.

METHODS

Studies comparing closed reduction percutaneous pinning vs. open reduction with pin fixation for treating pediatric lateral humeral condyle fractures were found by searching Pubmed, Embase, the Cochrane Library, and Web of Science databases, including randomized/non-randomized controlled, retrospective case-control, and prospective cohort studies. Furthermore, quality evaluation and data retrieval were conducted after the literature review. A meta-analysis was performed using RevMan 5.4 software to compare both groups' outcome measures.

RESULTS

This Meta-analysis incorporated eight studies with 856 cases. The Meta-analysis found no significant difference in functional outcomes, superficial infection, deep infection, poor fracture union, avascular necrosis of the humeral capitulum, or lateral spur formation between groups. However, the status of unaesthetic scars in the closed reduction percutaneous pinning group was superior.

CONCLUSIONS

For pediatric humeral lateral condylar fracture surgical therapy, the efficacy and safety of closed reduction percutaneous pinning vs. open reduction with pin fixation were not significantly different; closed reduction percutaneous pinning offered the benefit of eliminating unaesthetic scar. However, further high-quality research is required to verify the conclusions of this Meta-analysis.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/#myprospero, identifier CRD42023392451.

摘要

目的

比较闭合复位经皮穿针与切开复位穿针固定治疗小儿肱骨外侧髁骨折的有效性和安全性。

方法

通过检索Pubmed、Embase、Cochrane图书馆和Web of Science数据库,查找比较闭合复位经皮穿针与切开复位穿针固定治疗小儿肱骨外侧髁骨折的研究,包括随机/非随机对照、回顾性病例对照和前瞻性队列研究。此外,在文献回顾后进行质量评估和数据检索。使用RevMan 5.4软件进行Meta分析,比较两组的结局指标。

结果

本Meta分析纳入8项研究,共856例病例。Meta分析发现,两组在功能结局、浅表感染、深部感染、骨折愈合不良、肱骨小头缺血性坏死或外侧骨赘形成方面无显著差异。然而,闭合复位经皮穿针组的不美观瘢痕状况更好。

结论

对于小儿肱骨外侧髁骨折的手术治疗,闭合复位经皮穿针与切开复位穿针固定的有效性和安全性无显著差异;闭合复位经皮穿针具有消除不美观瘢痕的优势。然而,需要进一步的高质量研究来验证本Meta分析的结论。

系统评价注册

https://www.crd.york.ac.uk/prospero/#myprospero,标识符CRD42023392451。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/defc/10347534/32ab7e2f8288/fped-11-1205755-g001.jpg

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