经尺骨鹰嘴截骨入路治疗肱骨远端C型骨折临床疗效的Meta分析

Meta-analysis of the Clinical Efficacy of Transulnar Olecranon Osteotomy in the Treatment of Type C Fractures of the Distal Humerus

目的临床上针对肱骨远端C型骨折的手术入路选择仍有争议,因此本文对手术入路是否需要尺骨鹰嘴截骨进行系统评价。方法通过检索Pubmed、Embase、Cochrane、中国知网、万方、维普等数据库关于经尺骨鹰嘴截骨入路治疗肱骨远端C型骨折临床疗效相关研究,将符合纳入和排除标准的随机对照试验(RCT)进行文献质量评估和数据提取,并使用Revman 5.3软件对各项结局指标进行荟萃分析。结果共纳入11篇随机对照试验,共包括955例患者,其中经尺骨鹰嘴截骨入路有477例,非截骨入路有478例。荟萃分析显示:经尺骨鹰嘴截骨入路治疗肱骨远端C型骨折在总有效率,手术时间,术中出血量,并发症发生率均优于非截骨组(P<0.05),而骨折愈合时间、住院时间,两组差异无统计学意义(P>0.05)。结论经尺骨鹰嘴截骨入路具有更多优势,并发症低。本研究的数据可为临床治疗肱骨远端C型骨折的手术入路选择提供参考。

Objective Clinically,the choice of surgical approach for type C fractures of the distal humerus is still controversial.Therefore,this article systematically evaluates whether the surgical approach requires olecranon osteotomy.Methods By searching Pubmed,Embase,Cochrane,CNKI,Wanfang,Weipu and other databases on the clinical efficacy of the transulnar olecranon osteotomy approach for the treatment of type C fractures of the distal humerus,the RCTs that meet the inclusion and exclusion criteria were carried out.Literature quality assessment and data extraction,and the use of Revman 5.3 software to conduct meta-analysis of various outcome indicators.Results A total of 11 randomized controlled trials were included,including a total of 955 patients.Among them,there were 477 cases through the olecranon osteotomy approach and 478 cases through the non-osteotomy approach.The meta-analysis showed that the total effective rate,operative time,intraoperative blood loss,and complication rate of the treatment of type C fractures of the distal humerus through the olecranon osteotomy approach were better than those of the non-osteotomized group(P<0.05).There was no significant difference in fracture healing time and hospital stay between the two groups(P>0.05).Conclusions The transulnar olecranon osteotomy approach has more advantages and lower complications.It provides ideas for the selection of surgical approaches for the clinical treatment of type C fractures of the distal humerus.