Masquelet技术治疗骨折后骨缺损疗效的荟萃分析

Effectiveness of Masquelet technique for post-traumatic bone defects: a meta-analysis

[目的]系统评价Masquelet技术治疗创伤后骨缺损的治愈率及并发症的发生率。[方法]计算机检索Pubmed、EMbase、SCI、OVID循证数据库,收集Masquelet技术治疗骨折后骨缺损的研究,检索时间从建库至2018年4月。由2名研究者独立收集、筛选文献、提取资料,采用STATA12.0软件,依据效应指标为率的单臂研究荟萃分析方法进行分析。[结果]共纳入21个研究,包括594例患者。荟萃分析结果表明:融合所有研究报道的结果,Masquelet技术治疗骨折后骨缺损的治愈率为87.8%(CI 95%:84.9%～90.4%);术后再感染的发生率为9.2%(CI95%:5.3%～14%);术后骨不连的发生率为5.7%(CI 95%:2.8%～9.5%)。[结论]应用Masquelet技术治疗创伤后骨缺损有很高的治愈率,但仍然存在不容忽视的感染复发和骨不愈合的风险。

[Objective] To explore the healing and complication rate of Masquelet technique for post-traumatic bone defect by a meta-analysis. [Methods] Theses on Masquelet technique for post-traumatic bone defect were retrieved from Electronic databases, including PubMed, EMBASE SCI and OVID from beginning to April 2018. The literature were independently evaluated and collectively brought in by two reviewers, and then a meta-analysis was conducted based on single-arm design for the effect indicator as rate using STATA12.0 software. [Results] A total of 21 studies involving 594 patients were included into this study. The meta-analysis showed that the consolidated healing rate of bone defects managed by Masquelet technique was of(87.8%, CI 95%:84.9%~90.4%), while the reinfection rate proved of(9.2%, CI 95%:5.3%~14%), and nonunion rate of(5.7%, CI 95%:2.8%~9.5%). [Conclusion] The induced membrane technique might be effective treatment for post-traumatic bone defects, however, the risks of reinfection and nonunion could not be neglected.