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关节镜辅助下桡骨远端骨折的手术治疗:一项系统评价与Meta分析

Arthroscopic Assistance in Surgical Management of Distal Radius Fractures: A Systematic Review and Meta-analysis.

作者信息

Román-Veas Javier, Gutiérrez-Espinoza Héctor, Campos-Jara Christian, Martínez-García Darío

机构信息

Clínica Indisa, Santiago, Chile.

Escuela de Fisioterapia, Universidad de las Américas, Quito, Ecuador.

出版信息

J Wrist Surg. 2022 Oct 13;13(1):86-95. doi: 10.1055/s-0042-1757768. eCollection 2024 Feb.

Abstract

Wrist arthroscopy has become a commonly used tool for the management of adults with distal radius fractures (DRFs), although its implementation requires technical competence. This systematic review and meta-analysis appraised the available evidence concerning the contribution of wrist arthroscopy to the functional and radiological outcomes of patients with DRFs operated with arthroscopic assistance.  Randomized control trials were identified through five principal electronic databases on May 31, 2022: Web of Science, Scopus, EBSCO, Embase, and PubMed. Two authors independently performed the search and data extraction and assessed risk of bias (RoB) using the Cochrane RoB tool.  A total of 1,780 relevant abstracts and citations were extracted in the preliminary search, which yielded 6 trials that met the eligibility criteria, and 3 studies were included in the quantitative synthesis. The overall pooled mean difference (MD) estimate showed no significant difference in the Disabilities of the Arm, Shoulder, and Hand scores between surgical groups with and without arthroscopic assistance (MD = 0.77 points, 95% confidence interval = -6.58 to 5.03,  = 0.79), with substantial heterogeneity (I  = 85%).  There was low-quality evidence that wrist arthroscopy conveyed not clinically or statistically significant difference to functional outcomes of patients with DRFs. However, our findings are limited by the numbers of studies included and lack of long-term follow-up, although they do provide a good starting point for future quality research.

摘要

腕关节镜检查已成为治疗成人桡骨远端骨折(DRF)的常用工具,尽管其实施需要技术能力。本系统评价和荟萃分析评估了关于腕关节镜检查对在关节镜辅助下手术的DRF患者功能和影像学结果贡献的现有证据。

2022年5月31日,通过五个主要电子数据库(科学网、Scopus、EBSCO、Embase和PubMed)检索随机对照试验。两名作者独立进行检索和数据提取,并使用Cochrane偏倚风险(RoB)工具评估偏倚风险。

初步检索共提取了1780篇相关摘要和引文,其中6项试验符合纳入标准,3项研究纳入定量综合分析。总体合并平均差(MD)估计显示,在有无关节镜辅助的手术组之间,手臂、肩部和手部残疾评分无显著差异(MD = 0.77分,95%置信区间 = -6.58至5.03, = 0.79),存在高度异质性(I = 85%)。

有低质量证据表明,腕关节镜检查对DRF患者的功能结果无临床或统计学显著差异。然而,我们的研究结果受到纳入研究数量和缺乏长期随访的限制,尽管它们确实为未来的高质量研究提供了一个良好的起点。

相似文献

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Percutaneous pinning for treating distal radial fractures in adults.经皮穿针治疗成人桡骨远端骨折
Cochrane Database Syst Rev. 2020 Feb 7;2(2):CD006080. doi: 10.1002/14651858.CD006080.pub3.

本文引用的文献

1
History of Wrist Arthroscopy.腕关节镜检查史
J Wrist Surg. 2022 Apr 25;11(2):96-119. doi: 10.1055/s-0041-1740304. eCollection 2022 Apr.

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