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[腓骨固定在胫腓骨骨折中作用的Meta分析]

[Meta-analysis of the role of fibular fixation in tibiofibular fractures].

作者信息

Cong Lin-Lin, Jiang Pin-Pin, Guo Hua, Wang Hang, Che Xian-da, Wang Chun-Fang, Li Wen-Jin, Li Peng-Cui

机构信息

Department of Biochemistry and Molecular Biology, College of Basic Medicine, Shanxi Medical University, Taiyuan 030001, Shanxi, China; Key Laboratory of Bone and Soft Tissue Injury, Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China.

Key Laboratory of Bone and Soft Tissue Injury, Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China; Department of Orthopedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China.

出版信息

Zhongguo Gu Shang. 2024 Jan 25;37(1):74-80. doi: 10.12200/j.issn.1003-0034.20220290.

Abstract

OBJECTIVE

To compare the role and importance of fibular fixation in tibiofibular fractures by Meta-analysis.

METHODS

The literature related to the comparison of the efficacy of fixation of the fibula with or without fixation on the treatment of tibiofibular fractures was searched through the databases of China Knowledge Network, Wipu, Wanfang, The Cochrane Library, Web of science and Pubmed, and statistical analysis was performed using RevMan 5.3 software. The rates of malrotation, rotational deformity, internal/external deformity, anterior/posterior deformity, non-union, infection, secondary surgery and operative time were compared between the fibula fixation and non-fixation groups.

RESULTS

A total of 11 publications were included, six randomised controlled trials and five case-control trials, eight of which were of high quality. A total of 813 cases were included, of which 383 were treated with fibula fixation and 430 with unfixed fibulae.Meta-analysis results showed that fixation of the fibulae in the treatment of tibiofibular fractures reduced the rates of postoperative rotational deformity[=0.22, 95%(0.10, 0.45), <0.000 1] and internal/external deformity[=0.34, 95%(0.14, 0.84), =0.02] and promoted fracture healing [=0.76, 95%(0.58, 0.99), =0.04]. In contrast, the rates of poor reduction [=0.48, 95% (0.10, 2.33), =0.36], anterior/posterior deformity[=1.50, 95%(0.76, 2.96), =0.24], infection[=1.43, 95%(0.76, 2.72), =0.27], secondary surgery[=1.32, 95%(0.82, 2.11), =0.25], and operative time[=10.21, 95%(-17.79, 38.21), =0.47] were not statistically significant (>0.05) for comparison.

CONCLUSION

Simultaneous fixation of the tibia and fibula is clinically more effective in the treatment of tibiofibular fractures.

摘要

目的

通过Meta分析比较腓骨固定在胫腓骨骨折中的作用及重要性。

方法

通过中国知网、维普、万方、考克兰图书馆、科学网和PubMed数据库检索有关腓骨固定与否在胫腓骨骨折治疗中疗效比较的文献,使用RevMan 5.3软件进行统计分析。比较腓骨固定组和非固定组的旋转不良、旋转畸形、内/外畸形、前/后畸形、骨不连、感染、二次手术及手术时间发生率。

结果

共纳入11篇文献,其中6篇随机对照试验,5篇病例对照试验,8篇为高质量文献。共纳入813例病例,其中383例行腓骨固定,430例未固定腓骨。Meta分析结果显示,腓骨固定治疗胫腓骨骨折可降低术后旋转畸形发生率[比值比(OR)=0.22,95%可信区间(CI)(0.10,0.45),P<0.000 1]和内/外畸形发生率[OR=0.34,95%CI(0.14,0.84),P=0.02],并促进骨折愈合[OR=0.76,95%CI(0.58,0.99),P=0.04]。相比之下,复位不良发生率[OR=0.48,95%CI(0.10,2.33),P=0.36]、前/后畸形发生率[OR=1.50,95%CI(0.76,2.96),P=0.24]、感染发生率[OR=1.43,95%CI(0.76,2.72),P=0.27]、二次手术发生率[OR=1.32,95%CI(0.82,2.11),P=0.25]及手术时间[OR=10.21,95%CI(-17.79,38.21),P=0.47]比较差异无统计学意义(P>0.05)。

结论

胫腓骨骨折临床治疗中同时固定胫腓骨更有效。

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