内侧柱支撑重建结合锁定钢板内固定与锁定钢板内固定治疗肱骨近端骨折临床疗效的Meta分析

Meta-analysis of clinical efficacy of medial column support reconstruction combined with locking plate internal fixation and locking plate internal fixation in the treatment of proximal humeral fractures

目的通过对相关文献进行Meta分析,了解内侧柱支撑重建结合锁定钢板内固定与锁定钢板内固定治疗肱骨近端骨折临床疗效等方面的差异,评价两种手术方法的优劣。方法计算机检索PubMed、CochraneLibrary等外文数据库及万方、维普、CNKI等中文数据库,自2015年1月至2019年5月间发表的有关内侧柱支撑重建+锁定钢板内固定(locking plate fixation,LPF)与LPF治疗肱骨近端骨折的临床随机对照试验和回顾性对照研究,评价纳入文献的质量并提取数据,采用RevMan 5.3软件进行Meta分析。结果纳入10篇符合标准的文献,共707例患者,其中内侧柱支撑重建+LPF组353例,LPF组354例。在肩关节功能CMS评分、Neer评分的比较上,内侧柱支撑重建+LPF组优于LPF组;在住院时间、临床愈合时间及完成负重时间的比较上,内侧柱支撑重建+LPF组优于LPF组;在肱骨头内翻角度、肱骨头高度丢失、肱骨头高度比丢失方面,内侧柱支撑重建+LPF组低于LPF组。结论内侧柱支撑重建+LPF技术相对于单纯LPF治疗肱骨近端骨折具有住院时间短、骨折愈合快、完成负重早、术后肩关节功能恢复优良、复位固定好等特点。

Objective To understand the difference of clinical efficacy of medial column support reconstruction combined with locking plate internal fixation(LPF)and LPF in the treatment of proximal humeral fractures by Meta-analysis of relevant literature,and to evaluate the advantages and disadvantages of the two surgical methods.Methods Randomized controlled clinical trials and retrospective controlled studies on medial column support reconstruction combined with LPF and LPF in the treatment of proximal humeral fractures were published from January 2015 to May 2019 in Pubmed,Cochrane library and other foreign language databases.The quality of the included literature was evaluated and the data were extracted.RevMam5.3 software was used for Meta-analysis.Results Randomized controlled clinical trials and retrospective controlled studies on medial column support reconstruction combined with LPF and LPF in the treatment of proximal humeral fractures were published from January 2015 to May 2019 in Pubmed,Cochrane library and other foreign language databases.The quality of the included literature was evaluated and the data were extracted.RevMam5.3 software was used for Meta-analysis.Conclusion Compared with LPF alone,medial column support reconstruction combined with LPF has the advantages of shorter hospitalization time,faster fracture healing,early weight bearing,excellent shoulder function recovery and good reduction and fixation.