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关节镜辅助固定与切开固定治疗冠状突骨折的手术疗效及并发症发生率:一项系统评价和荟萃分析。

Surgical outcomes and complication rates of arthroscopic-assisted fixation versus open fixation for coronoid fractures: A systematic review and meta-analysis.

作者信息

Kholinne Erica, Liu Hua, Singjie Leonard Christianto, Anastasia Maria, Kwak Jae-Man, Jeon In-Ho

机构信息

Faculty of Medicine, Universitas Trisakti, Jakarta, Indonesia.

Department of Orthopedic Surgery, St Carolus Hospital, Jakarta, Indonesia.

出版信息

Shoulder Elbow. 2025 Jan;17(1):86-95. doi: 10.1177/17585732241229636. Epub 2024 Feb 16.

Abstract

BACKGROUND

Coronoid fractures often occur with complex elbow dislocations, accounting for 15% of elbow fractures. The effectiveness of open reduction internal fixation (ORIF) versus arthroscopic-assisted reduction internal fixation (ARIF) surgeries for coronoid fractures remains uncertain. This study aimed to compare the outcomes of these two surgical approaches in treating varus posteromedial injuries.

METHODS

This study was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study protocol was registered with PROSPERO. The primary outcomes assessed in this study were the functional outcomes measured by the Mayo Elbow Performance Score (MEPS) and the complications associated with each surgical approach.

RESULTS

Analysis of the data from 759 patients included in this study revealed that the mean postoperative MEPS score was higher in the ARIF group compared to the ORIF group (97.5 Vs. 90.7), with the mean improvement in MEPS was 16.6 points (19 for ORIF and 14.3 for ARIF). The complication rate in the ORIF group was 24.6%, while the ARIF group reported a complication rate of 6%.

CONCLUSION

This study suggests that ARIF surgery can yield comparable and promising outcomes to ORIF surgery for coronoid fractures.

LEVEL OF EVIDENCE

IV.

摘要

背景

冠突骨折常伴有复杂的肘关节脱位,占肘关节骨折的15%。切开复位内固定术(ORIF)与关节镜辅助复位内固定术(ARIF)治疗冠突骨折的疗效仍不确定。本研究旨在比较这两种手术方法治疗内翻后内侧损伤的效果。

方法

本研究按照系统评价和Meta分析的首选报告项目指南进行并报告。研究方案已在国际前瞻性注册系统(PROSPERO)注册。本研究评估的主要结局是通过梅奥肘关节功能评分(MEPS)衡量的功能结局以及与每种手术方法相关的并发症。

结果

对本研究纳入的759例患者的数据进行分析发现,ARIF组术后MEPS评分均值高于ORIF组(97.5对90.7),MEPS的平均改善值为16.6分(ORIF组为19分,ARIF组为14.3分)。ORIF组的并发症发生率为24.6%,而ARIF组报告的并发症发生率为6%。

结论

本研究表明,对于冠突骨折,ARIF手术可产生与ORIF手术相当且有前景的结果。

证据级别

IV级。

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本文引用的文献

1
Coronoid fractures and traumatic elbow instability.冠状突骨折与创伤性肘关节不稳定。
JSES Int. 2023 Apr 20;7(6):2587-2593. doi: 10.1016/j.jseint.2023.03.020. eCollection 2023 Nov.

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