Pauwels三型股骨颈骨折不同内固定方式的meta分析

A meta-analysis of different internal fixation strategies of Pauwels Ⅲ femoral neck fractures

目的·系统评价空心钉(cannulated screw,CS)与滑动髋螺钉(sliding hip screw,SHS)固定Pauwels三型股骨颈骨折的疗效和功能恢复情况。方法·计算机检索三大英文数据库Pub Med、Embase、Cochrane,及中文数据库CNKI、Sinomed,使用Revman5.26软件对纳入文献进行meta分析。结果·最终选出6篇临床研究,共包含病例350例,其中CS固定组213例,SHS固定组137例。通过分析得出,SHS固定术后骨不连率显著低于CS固定,但是CS固定手术时间更短。结论·对于Pauwels三型股骨颈骨折,SHS可以显著减少术后骨不连的发生,但是手术过程相对复杂,并存在术中出血量大、术后功能评分低的趋势。

Objective·To compare the clinical and functional outcomes of cannulated screw(CS)with sliding hip screw(SHS)in the fixation of PauwelsⅢfemoral neck fractures systematically.Methods·In the meta-analysis,articles were searched from Pubmed database,Embase database,Cochrane library,CNKI database,and Sinomed database.The selected articles were analyzed by Revman 5.26 software.Results·Six clinical studies met the inclusion criteria.A total of 350 patients including 213 with CS fixations and 137 with SHS fixations were pooled in the meta-analysis.The results showed that the non-union rate in SHS group was significantly lower than that in CS group.However,the surgery time was significantly shorter in CS group.Conclusion·SHS fixation has the advantage of reducing postoperative non-union rate in PauwelsⅢfemoral neck fractures,but the operative process is relatively complicated,which seemingly causes more blood loss during surgery,and may lead to a less satisfactory functional recovery.