肩关节脱位外旋固定疗效的meta分析

Efficacy of internal rotation versus external rotation immobilization after manipulatively reducing for primary shoulder dislocation: a meta-analysis

目的分析系统性评价初发性肩关节脱位手法复位后内旋位固定与外旋位固定疗效的差异。方法计算机检索Cochrane图书馆（2013年第10期）、MEDLINE（1966年至2013年10月）、EMBase（1966年1月至2013年10月）、中国生物医学文献数据库（1979年1月至2013年10月）、Pub Med（1966年6月至2013年10月）、万方数据库和维普数据库以及手工检索中文骨科期刊,收集关于初发性肩关节脱位手法复位后内旋位固定与外旋位固定疗效的相关文献。筛选符合纳入标准的文献,对其进行严格的质量评价后应用Rev Man 5.2软件进行meta分析。结果符合纳入标准的文献共7篇,包含640例患者。meta分析结果显示：两种固定方法治疗初发性肩关节脱位后,肩关节脱位复发率组间差异有统计学意义（OR=2.43,95%CI：1.16~5.11,P=0.02）,外旋位固定组患者治疗后肩关节再脱位发生率明显低于内旋组。结论初发性肩关节脱位手法复位后应用外旋位固定可明显降低患者肩关节脱位的复发率,优于传统的内旋位固定法。

Objective To evaluate system atically the efficacy of internal rotation versus external rotation immobilization after manipulatively reducingfor primary shoulder dislocation. Methods The literature of comparison between internal rotation and external rotation immobilization after manipulatively reducingfor primary shoulder dislocation was searched and collected from Cochrane Library（ Section 10,2013）,M EDLINE Database（1966-October 2013）,EM Base Database（ January1966-October 2013）,Chinese Biomedical Literature Database（ January 1979-October 2013）,Pub M ed（June 1966-October 2013）,WanfangDatabase and VIP database and manually in Chinese orthopedic journals. After quality assessment on literature meetingthe inclusion criteria, meta-analysis was performed with the with RevM an5. 2 software. Results Seven articles met the inclusion criteria and involved 640 patients. The meta-analysis showed that the recurrence rate in external rotation immobilization group was significantly lower than that in internal rotation immobilization group in treatment of primary shoulder dislocation（ OR = 2. 43, 95% CI： 1. 16-5. 11, P = 0. 02）.Conclusion The external rotation immobilization is more effective than the traditional internal rotation method in reducing the recurrence rate for primary shoulder dislocation.