摘要
目的系统性评价微创与切开复位内固定治疗移位型跟骨关节内骨折(displaced intraarticular calcaneus fracture,DIACFs)的临床疗效。方法全面检索Pub Med、Embase、Cochrane and Google Scholar等数据库,检索时间截止至2017年7月,纳入微创与切开复位内固定治疗移位型跟骨关节内骨折的随机对照研究(randomized controlled trial,RCT),对RCT研究采用Cochrane手册针对纳入文献进行的偏倚风险评估,由2位作者独立提取及分析数据,采用Review Manager 5.3软件对所得的数据进行Meta分析。结果共纳入7篇随机对照试验研究。在对Bohler’s角[MD=0.48,95%CI(-0.24,1.19),P=0.19]、Gissanes’s角[MD=1.51,95%CI(-1.6,3.18),P=0.08]的恢复和AOFAS评分[MD=1.59,95%CI(-0.67,3.85),P=0.17]方面两组差异无统计学意义,在MFS评分[RR=1.08,95%CI(1.01,1.17),P=0.03]、住院时间[MD=-2.13,95%CI(-2.25,-2.01),P<0.00001]、手术时间[MD=-37.78,95%CI(-59.12,-16.43),P=0.0005]及术后并发症[RR=0.2,95%CI(0.15,0.41),P<0.00001]两组差异有统计学意义。结论微创手术和传统切开复位内固定手术在治疗移位型跟骨内骨折中具有相似的固定效果和功能恢复,但是微创组的术后并发症、住院时间和手术时间均优于切开复位内固定组。
Objective To systematically evaluate minimally invasive surgery versus open reduction and internal fixation in the management of displaced intra-articular calcaneal fractures （ DIACFs ）. Methods A comprehensive search of randomized controlled trials （ RCTs ） on minimally invasive surgery versus open reduction and internal fixation for DIACFs published up to July 2017 was performed in PubMed, Cochrane Library, Embase Library and Google Scholar. For the RCTs. We used the Cochrane Handbook to assess the methodological quality. Two of the authors independently extracted the articles and predefined data. Statistical analyses were performed using Review Manager 5.3 software. Results Seven RCTs were included in this meta-analysis after systematical retrieval and screening. There were no significant differences in the recovery of Bohler＆#39;s angles [ MD = 0.48, 95% CI （ -0.24, 1.19 ）, P = 0.19 ], the recovery of Gissanes＆#39;s angles [ MD = 1.51, 95% CI （ -1.6, 3.18 ）, P = 0.08 ] and AOFAS score [ MD = 1.59, 95% CI （ -0.67, 3.85 ）, P = 0.17 ]. However, significant differences existed in MFS score [ RR = 1.08, 95% CI （ 1.01, 1.17 ）, P = 0.03 ], length of incision [ MD = -2.13, 95% CI （ -2.25, -2.01 ）, P 〈 0.00001 ], length of operation time [ MD = -37.78, 95% CI （ -59.12, -16.43 ）, P = 0.0005 ] and postoperative complications [ RR = 0.2, 95%CI （ 0.15, 0.41 ）, P 〈 0.00001 ]. Conclusions The two surgical methods have similar fixation effects and functional recovery, but the postoperative complications, length of stay and operation time of the minimally invasive group are better than those of the open reduction and internal fixation group.
作者
喻雅婷
蒋仁莲
YU Ya-ting;JIANG Ren-lian(Department of Orthopedics, Yongchuan Hospital Chongqing Medical University, Chongqing, 402160, China)
出处
《中国骨与关节杂志》
CAS
2017年第12期924-931,共8页
Chinese Journal of Bone and Joint
关键词
骨折固定术
内
跟骨
最小侵入性外科手术
META分析
Fracture fixation
internal
Calcaneus
Minimally invasive surgical procedures
Meta-analysis
作者简介
通讯作者：蒋仁莲，Email：jiangrenlian0801@sina．com
