髓内钉与锁定钢板治疗肱骨近端骨折临床疗效的Meta分析

Meta-analysis of Proximal Humeral Fractures Treated with Intramedullary Nail and Locking Plate

目的:系统评价髓内钉与锁定钢板治疗肱骨近端骨折的临床疗效。方法:使用计算机检索Pubmed,Embase,Cochrane Library,万方,知网,VIP数据库,检索从建库到2019年12月的所有关于髓内钉与锁定钢板治疗肱骨近端骨折的随机对照试验。由2名评价者对独立纳入的文献进行数据提取后,用RevMan5.3软件进行Meta分析。结果:按照规定的文献检索方式,最终纳入7篇RCT研究,研究中共纳入患者412例,分析结果显示:在手术时间、术中出血量、骨折愈合时间方面髓内钉组优于锁定钢板组,两者之间差异具有统计学意义;在术后6个月Constant-Murley评分方面,两者之间差异无统计学意义。结论:治疗肱骨近端骨折髓内钉与锁定钢板均可取得良好疗效,但在减少手术时间、术中出血量以及缩短骨折愈合时间方面髓内钉更具优势,但仍需高质量的临床研究进一步验证。

Objective To systematically evaluate the clinical efficacy of intramedullary nail and locking plate in the treatment of proximal humeral fractures.Methods PubMed,Embase,Cochrane Library,Wanfang,CNKI and VIP database were searched by computer.All randomized controlled trials about intramedullary nail and locking plate in the treatment of proximal humeral fractures from the establishment of the database to December 2019 were searched.After the data which were extracted from the literature independently included by two evaluators,the Meta-analysis was carried out by RevMan5.3 software.Results According to the prescribed literature search method,7 articles and a total of 412 patients were included in the study.The results showed that the time of operation,the amount of intraoperative blood loss and the time of fracture healing the intramedullary nail group were better than those of the locking plate group.The difference between the two groups was statistically significant.There was no significant difference in Constant-Murley score atthe 6th month after operation.Conclusion Both intramedullary nail and locking plate can achieve good results in the treatment of proximal humeral fractures,but intramedullary nails have more advantages in reducing operation time,intraoperative blood loss and shortening fracture healing time.However,it still needs to be further verified by high-quality clinical studies.