腕关节镜与切开复位内固定治疗桡骨远端骨折临床疗效的Meta分析

Clinical Efficacy of Wrist Arthroscopy and Open Reduction and Internal Fixation in Treatment of Distal Radius Fracture:A Meta-Analysis

目的对腕关节镜与切开复位内固定治疗桡骨远端骨折的临床疗效及安全性进行系统评价。方法计算机检索CNKI、Wanfang、VIP、CBM、Pubmed、Cochrane Library数据库,检索时间限定为建库至2021年4月,根据纳入和排除标准,收集腕关节镜与切开复位内固定治疗桡骨远端骨折的临床对照试验及回顾性研究,2名研究人员独立对检索到的文献进行筛选、评价和数据提取,使用RevMan 5.3软件进行Meta分析。结果最终纳入14篇文献,共1040例患者,其中腕关节镜组497例,切开复位内固定组543例。分析结果显示:在Gartland-Werley评分、VAS疼痛评分、不良反应发生率、腕关节功能优良率、腕关节活动度背伸、桡偏、尺偏、旋前、旋后方面,腕关节镜组优于切开复位内固定组(均P<0.05);在DASH评分、骨折愈合时间、腕关节活动度屈曲方面,腕关节镜组与切开复位内固定组差异无统计学意义(均P>0.05)。结论与切开复位内固定相比,腕关节镜治疗桡骨远端骨折在改善腕关节功能、提高腕关节活动度、降低不良反应发生率方面具有一定的优势。

Objective To explore the clinical efficacy and safety of wrist arthroscopy and incision complex for the treatment of distal radius fracture by systematic review and meta-analysis.Methods The CNKI,Wanfang,VIP,CBM,Pubmed and Cochrane Library were searched.The retrieval time was limited from the establishment of database to April 2021.Based on the inclusion and exclusion criteria,randomized controlled trials of wrist arthroscopy and open reduction and internal fixation in the treatment of distal radius fracture were collected.Two researchers independently performed screening,evaluation,and data extraction on the retrieved literature,and then RevMan 5.3 software was used for meta-analysis.Results A total of 1040 patients were included out of 14 trials,including 497 in the arthroscopic group and 543 in the open reduction and internal fixation group.The results of meta-analysis showed that:In terms of Gartland-Werley score,VAS pain score,incidence of adverse reaction,excellent rate of wrist function,wrist range of motion(extension,radial deviation,ulnar deviation,pronation and supination),the wrist arthroscopy group was better than the open reduction and internal fixation group(all P<0.05).In terms of DASH score,fracture healing time,wrist mobility(flexion),there was no significant difference between the wrist arthroscopy group and the open reduction and internal fixation group(all P>0.05).Conclusion Compared with open reduction and internal fixation,the wrist arthroscopy can better improve the function of wrist joint,increase the mobility of the wrist joint,and reduce the incidence of adverse reactions.