克氏针与钢板固定桡骨远端骨折疗效的荟萃分析

Plates versus K-wires for treatment of distal radius fractures:a meta-analysis

[目的]用Meta分析定量评价克氏针与钢板固定桡骨远端骨折的疗效和安全性。[方法]计算机检索Pub Med、EMBASE、Cochrane Library、中国生物医学文献数据库、中国期刊全文数据库、中国科技期刊全文数据库关于克氏针与钢板固定桡骨远端骨折的随机对照试验,由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险/方法学质量后,采用Rev Man 5.3软件进行Meta分析。[结果]共纳入8篇随机对照试验,Meta分析结果显示:钢板和克氏针治疗桡骨远端骨折术后3个月DASH评分[MD=-7.54,95%CI(-10.66,-4.42),P<0.001]、浅表部位感染发生率[OR=0.43,95%CI(0.23,0.79),P=0.007]、总并发症的发生率[OR=0.21,95%CI(0.15,0.29),P<0.001]方面差异有统计学意义。而在术后12个月DASH评分方面[MD=-2.87,95%CI(-6.48,0.73),P=0.12],两组差异无统计学意义。[结论]钢板内固定治疗桡骨远端骨折在DASH评分和降低术后并发症方面优于克氏针固定。

[Objective] To quantitatively evaluate the efficacy and safety of plates versus Kirschner wires （K-wires） for treatment of distal radius fractures by a meta-analysis. [Methods] We searched PubMed, Embase, the Cochrane Library, Chinese Biomedical Literature Database, Chinese Journal Full-text Database, and Chinese Scientific Journals Full-text Data- base for randomized controlled trials comparing plates with K-wires for distal radius fractures. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias and methodological quality of included studies. Then, a meta-analysis was performed using RevMan 5.3. [Results] Eight randomized controlled trials were included. The meta-analy- sis showed that there were significant differences between the plates group and the K-wires group in 3-month DASH score [MD =-7.54, 95% CI （-10.66, -4.42）, P 〈0.00001], superficialinfection rate [OR=0.43, 95% CI （0.23, 0.79）, P= 0.007], and overall postoperative complications rate [OR=0.21, 95% CI （0A5, 0.29）, P〈0.00001] . However, there was no significant difference between the two groups in 12-month DASH score [MD =-2.87, 95%CI （-6.48, 0.73）, P= 0.12] . [Conclusions] Current clinical evidence indicates that the plates is superior to K-wires for distal radius fractures in DASH score and overall postoperative complication rate.