关节镜辅助闭合复位内固定和切开复位内固定治疗跟骨骨折的Meta分析

Comparison of arthroscope-assisted closed reduction and percutaneous screw fixation versus ORIF in the treatment of calcaneal fractures:a Meta-analysis

目的采用Meta分析比较关节镜辅助下闭合复位内固定和切开复位内固定治疗SanderⅡ~Ⅲ型跟骨骨折的疗效。方法利用计算机系统检索Medline,Embase,CENTRAL,中国知网数据库,维普数据库,万方数据库中关于跟骨骨折关节镜辅助闭合复位内固定治疗和切开复位内固定治疗的中英文文献,按照纳入排除标准采集数据,再利用Revman 5.0软件进行Meta分析,比较各评价指标差异。结果最终纳入8篇文献,共计430例患者(450例患足)。关节镜辅助手术组209例患者,219例患足。切开复位内固定组221例患者,231例患足。结果显示关节镜辅助组手术时间和住院时间较短,手术切口并发症发生率较低,Gissane角恢复更加令人满意。两种手术方式Bohler角和AOFAS评分比较,差异无统计学意义。结论关节镜辅助下闭合复位内固定治疗跟骨骨折有比较明显的优势,不失为一种较优的选择。

Objective To compare the efficacy between arthroscope-assisted closed reduction and percutaneous screw(AACRPSF)and ORIF in the treatment of SanderⅡ-Ⅲcalcaneal fractures by Meta-analysis.Methods Databases of PubMed,Cochrane Central Register of Controlled Trials(CENTRAL),EMbase,the ISI web of knowledge databases,VIP database for Chinese technical periodicals,China national knowledge infrastructure(CNKI),Chinese biomedical literature database(CBM),and Wanfang data were searched from January 2009 to December 2018.Chinese and English literature about AACRPSF and ORIF treatment of calcaneal fractures were collected according to the inclusion and exclusion criteria.A Meta-analysis was performed using the RevMan 5.3 software.Results 8 articles were included,involving a total of 430 patients(450 feet).There were 209 patients(219 feet)in the AACRPSF group.221 patients(231 feet)were treated with ORIF.The results showed that the AACRPSF had shorter operation time and hospitalization time,lower incidence of surgical incision complications,and more satisfactory Gissane angle recovery.There were no significant differences in the Bohler angle and the AOFAS scores for the two surgical procedures.Conclusion AACRPSF has obvious advantages in the treatment of calcaneal fractures,and it is a considerable choice.