Wang Zhongqing, Xiong Xianmei, Lu Zesheng, Gao Yijia
The First Clinical School of Guangzhou, University of Chinese Medicine, Guangzhou, China.
The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.
Eur J Trauma Emerg Surg. 2024 Apr;50(2):383-394. doi: 10.1007/s00068-023-02384-9. Epub 2023 Nov 21.
The application of the suprapatellar (SP) approach has challenged the traditional infrapatellar (IP) approach in the surgery treatment of tibial shaft fractures, yet the advantages and disadvantages still remain controversial. We included more high-quality studies for this meta-analysis and systematic review to evaluate the clinical outcomes and prognosis of both approaches and thus to provide new ideas for surgeons.
We searched literatures from PubMed, Cochrane Library, Web of Science, and EMBASE databases from January 2000 to December 2022. We extracted general information including sample size, gender, proportion of open fracture, follow-up time, and outcome indicators including entrance accuracy, fluoroscopy time, operation time, intraoperative blood loss, Lysholm score, VAS pain score, range of motion (ROM) function score, reposition accuracy, and revision cases. Cochrane Collaboration's tool and the Newcastle-Ottawa Scale were used to evaluate literature qualities. Meta-analysis was performed using RevMan 5.4 software.
A total of 23 studies were generated that qualified for inclusion, 17 of which were used for meta-analysis. This study found statistically significant differences in coronal plane entrance accuracy, fluoroscopy time, Lysholm score, and VAS pain score.
The results of our meta-analysis showed that the SP approach was significantly better than the IP approach in angle and distance entrance accuracy of coronal plane, angle entrance accuracy of sagittal plane, fluoroscopy time, Lysholm score, and VAS pain score. There were no significant differences in sagittal angle accuracy, operative time, intraoperative blood loss, and ROM score.
在胫骨干骨折的手术治疗中，髌上（SP）入路的应用对传统的髌下（IP）入路提出了挑战，但其优缺点仍存在争议。我们纳入了更多高质量研究进行这项荟萃分析和系统评价，以评估两种入路的临床结果和预后，从而为外科医生提供新思路。
我们检索了2000年1月至2022年12月期间来自PubMed、Cochrane图书馆、Web of Science和EMBASE数据库的文献。我们提取了一般信息，包括样本量、性别、开放性骨折比例、随访时间，以及结果指标，包括入口准确性、透视时间、手术时间、术中失血量、Lysholm评分、视觉模拟评分法（VAS）疼痛评分、活动范围（ROM）功能评分、复位准确性和翻修病例。使用Cochrane协作工具和纽卡斯尔-渥太华量表来评估文献质量。使用RevMan 5.4软件进行荟萃分析。
共纳入23项符合条件的研究，其中17项用于荟萃分析。本研究发现，在冠状面入口准确性、透视时间、Lysholm评分和VAS疼痛评分方面存在统计学显著差异。
我们的荟萃分析结果表明，在冠状面角度和距离入口准确性、矢状面角度入口准确性、透视时间、Lysholm评分和VAS疼痛评分方面，SP入路明显优于IP入路。在矢状角准确性、手术时间、术中失血量和ROM评分方面无显著差异。
