下颌骨髁突骨折治疗的Meta分析

Meta-analysis of the Mandibular Condylar Fractures Treatment

目的应用Meta分析方法系统评价下颌骨髁突骨折保守治疗和手术治疗的疗效。方法以下颌骨髁突、颞下颌关节、下颌骨骨折、坚固内固定、关节固定技术为关键词,利用MEDLINE、EMBASE、The Cochrane Library和CNKI数据库检索中英文文献,按标准筛选文献,进行文献评价和Meta分析。结果17篇文献符合纳入标准,其中1篇文献是随机对照研究,另外16篇为回顾性对照研究。手术组和非手术组比较,术后最大张口度、最大前伸距离、张口偏斜的发生率无显著性差异,术后错、颞下颌关节疼痛和弹响的发生率有显著性差异(P<0.05)。结论因为纳入研究的文献质量较低,尽管Meta分析的一些结果有统计学意义,但对于手术治疗或保守治疗髁突骨折的评价不是结论性的,需要进行更多高质量的研究。

Objective To systematically evaluate the open and closed treatment of condylar fracture using Metaanalysis system. Methods Using the key words ＂mandibular condyle＂, ＂temporomandibular joint＂, ＂mandibular fracture＂, ＂internal fracture fixation＂ ,and ＂jaw fixation techniques＂, a search for the objective articles was performed from following data base：MEDLINE, CCTR, EMBASE and CNKI. These articles contained data on at learnt one of the follow：postoperative maximum mouth opening, deviation on opening, protrusion, and joint pain. Results Seventeen articles met the final selection criteria：except for one randomized clinical trial study, all the articles were retrospective studies. There was no significant difference in maximum mouth opening,protrusion and deviation on opening. The significance differences were found in the malocclusion and joint pain and snap. Conclusion Because of the relatively poor query of the available data and great variation in the manner in which the various articles were reported, it was not possible to perform a reliable meta-analysis. The results of the meta-analysis are inconclusive regarding whether open and closed methods should be used for the management of mandibular condylar fractures. There is a need for better standardization of data collection in future studies to accurately compare the two methods.