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肱骨近端骨折中 CFR-PEEK 与钛板的比较:一项荟萃分析。

Comparison between CFR-PEEK and titanium plate for proximal humeral fracture: A meta-analysis.

机构信息

Department of Joint Surgery, Tianjin Hospital, No. 406, Jiefang Nan Road, Tianjin, 300211 People's Republic of China.

出版信息

Jt Dis Relat Surg. 2024 Jul 8;35(3):483-490. doi: 10.52312/jdrs.2024.1611.

DOI:10.52312/jdrs.2024.1611
PMID:39189556
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11411899/
Abstract

OBJECTIVES

The aim of the present meta-analysis was to compare the efficacy and safety of the carbon fiber-reinforced polyetheretherketone (CFR-PEEK) and titanium plate for the treatment of proximal humeral fractures (PHFs) from clinical comparative trials.

MATERIALS AND METHODS

A comprehensive search of English databases was carried out, such as PubMed, Web of Science, ScienceDirect, Springer and Cochrane Library databases. The RevMan version 5.1 software was applied for statistical analysis, and the mean difference (MD) and risk difference (RD) as the combined variables, and "95%" as the confidence interval (CIs).

RESULTS

One randomized-controlled trial and five retrospective controlled studies including 282 PHFs were considered eligible and finally included. Meta-analysis demonstrated that there were significant differences in Constant score (CS) (MD=9.23; 95% CI: 5.02, 13.44; p<0.0001), anterior elevation (MD=18.83; 95% CI: 6.27, 31.38; p=0.003), lateral elevation (MD=18.42; 95% CI: 3.64, 33.19; p=0.01) and adduction (MD=3.53; 95% CI: 0.22, 6.84; p=0.04). No significant differences were observed regarding Constant score compared to the contralateral shoulder, Oxford Shoulder Score, internal rotation, external rotation, screw perforation and cutout, varus/valgus malalignment, humeral head collapse/necrosis, implant removal, and revision surgery between the two groups.

CONCLUSION

Compared to titanium plate, CFR-PEEK plate showed better Constant score, anterior elevation, lateral elevation and adduction in treating PHFs. The complications are comparable to those achieved with conventional titanium plates.

摘要

目的

本荟萃分析的目的是比较碳纤维增强聚醚醚酮(CFR-PEEK)与钛板治疗肱骨近端骨折(PHF)的疗效和安全性。

材料与方法

全面检索了英文数据库,如 PubMed、Web of Science、ScienceDirect、Springer 和 Cochrane Library 数据库。使用 RevMan 版本 5.1 软件进行统计学分析,以均数差值(MD)和风险差(RD)作为合并变量,置信区间(CI)为“95%”。

结果

共纳入 1 项随机对照试验和 5 项回顾性对照研究,共计 282 例 PHF。荟萃分析显示,Constant 评分(CS)(MD=9.23;95%CI:5.02,13.44;p<0.0001)、前屈抬高(MD=18.83;95%CI:6.27,31.38;p=0.003)、外展抬高(MD=18.42;95%CI:3.64,33.19;p=0.01)和内收(MD=3.53;95%CI:0.22,6.84;p=0.04)差异均有统计学意义。两组间 CS 与对侧肩部、牛津肩评分、内旋、外旋、螺钉穿孔和脱出、内翻/外翻畸形、肱骨头塌陷/坏死、植入物取出和翻修手术比较,差异均无统计学意义。

结论

与钛板相比,CFR-PEEK 板治疗 PHF 时具有更好的 CS、前屈抬高、外展抬高和内收功能。并发症与传统钛板相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6112/11411899/3aa70ab09b8e/JDRS-2024-35-3-483-490-F2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6112/11411899/3bb4b35e473c/JDRS-2024-35-3-483-490-F1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6112/11411899/3aa70ab09b8e/JDRS-2024-35-3-483-490-F2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6112/11411899/3bb4b35e473c/JDRS-2024-35-3-483-490-F1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6112/11411899/3aa70ab09b8e/JDRS-2024-35-3-483-490-F2.jpg

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本文引用的文献

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J Clin Med. 2023 Oct 31;12(21):6881. doi: 10.3390/jcm12216881.
2
Writing for Joint Diseases and Related Surgery (JDRS): There is something new and interesting in this article!为《关节疾病与相关外科手术》(JDRS)撰写文章:本文有一些新颖有趣的内容!
Jt Dis Relat Surg. 2023 Sep 21;34(3):533. doi: 10.52312/jdrs.2023.57916.
3
The medial cortical ratio as a risk factor for failure after surgical fixation of proximal humerus fractures in elderly patients.
内侧皮质比率作为老年患者肱骨近端骨折手术后失败的风险因素。
Jt Dis Relat Surg. 2023 Apr 27;34(2):432-438. doi: 10.52312/jdrs.2023.1073.
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Conservative Treatment of Proximal Humerus Fractures: When, How, and What to Expect.肱骨近端骨折的保守治疗:时机、方法及预期效果
Curr Rev Musculoskelet Med. 2023 Feb;16(2):75-84. doi: 10.1007/s12178-022-09817-9. Epub 2022 Dec 23.
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Minimum 2-year results of the second-generation CFR-PEEK locking plate on the proximal humeral fracture.第二代 CFR-PEEK 锁定板治疗肱骨近端骨折的 2 年随访结果。
Eur J Orthop Surg Traumatol. 2023 May;33(4):1307-1314. doi: 10.1007/s00590-022-03298-9. Epub 2022 May 27.
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Eur J Trauma Emerg Surg. 2021 Dec;47(6):2055-2064. doi: 10.1007/s00068-020-01380-7. Epub 2020 May 24.