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成人同侧股骨颈和股骨干骨折治疗中重建钉与双植入物的比较:一项荟萃分析和系统评价

Comparison of reconstruction nails versus dual implants in the treatment of ipsilateral femoral neck and shaft fractures in adults: a meta-analysis and systematic review.

作者信息

Zhao Yongchao, Li Jian, Liu Yadong, Cui Guanlu, Li Zhengwei

机构信息

Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin Province, China.

Department of Emergency and Critical Care, The Second Hospital of Jilin University, Changchun, China.

出版信息

BMC Musculoskelet Disord. 2023 Oct 9;24(1):800. doi: 10.1186/s12891-023-06933-6.

Abstract

OBJECTIVE

There is no consensus on the optimal treatment for ipsilateral femoral neck and shaft fractures. This meta-analysis aims to assess the effectiveness of reconstruction nails and dual implants in treating ipsilateral femoral neck and shaft fractures to provide a basis for decision-making when selecting the optimal approach.

METHODS

Relevant articles were retrieved from Pubmed, Embase, and Cochrane databases using the keywords "neck of femur", "shaft" and "fracture fixation" from inception until November 17, 2022. The screening process of the studies was conducted independently by two assessors, who assessed each study's eligibility and two assessors assessed the quality. Then compared differences in outcome measures using RevMan 5.3 software.

RESULTS

A total of ten retrospective cohort studies were included. There were no significant differences in union time, union rate, union-related complications (malunion, nonunion, delayed union) of femoral neck and shaft fractures, osteonecrosis of the femoral head, and functional outcomes (Friedman-Wyman scoring system) (P > 0.05).

CONCLUSION

Our pooled estimates indicated that reconstruction nails and dual implants for ipsilateral femoral neck and shaft fractures could yield satisfactory surgical results, and that there is no difference between the two treatment methods.

TRIAL REGISTRATION

This meta-analysis was registered on the PROSPERO website (registration number: CRD42022379606).

摘要

目的

对于同侧股骨颈和股骨干骨折的最佳治疗方法尚无共识。本荟萃分析旨在评估重建钉和双植入物治疗同侧股骨颈和股骨干骨折的有效性,为选择最佳治疗方法时的决策提供依据。

方法

使用关键词“股骨颈”“骨干”和“骨折固定”,从创刊至2022年11月17日在Pubmed、Embase和Cochrane数据库中检索相关文章。研究的筛选过程由两名评估者独立进行,他们评估每项研究的 eligibility,两名评估者评估质量。然后使用RevMan 5.3软件比较结果指标的差异。

结果

共纳入10项回顾性队列研究。股骨颈和股骨干骨折的愈合时间、愈合率、愈合相关并发症(畸形愈合、不愈合、延迟愈合)、股骨头坏死和功能结局(Friedman-Wyman评分系统)方面均无显著差异(P>0.05)。

结论

我们的汇总估计表明,重建钉和双植入物治疗同侧股骨颈和股骨干骨折可产生令人满意的手术效果,且两种治疗方法之间无差异。

试验注册

本荟萃分析已在PROSPERO网站注册(注册号:CRD42022379606)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b92/10561477/1e58ff4e6384/12891_2023_6933_Fig2_HTML.jpg

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