摘要
目的 系统评价股骨颈动力交叉钉系统(FNS)与空心螺钉(CS)治疗成人股骨颈骨折在围术期及恢复期的疗效.方法 检索知网、万方、维普、CBM、PubMed、Embase、Cochrane数据库,收集有关2种内固定方案疗效比较的相关文献.采用Review Manager 5.3软件对最终纳入研究的文献进行Meta分析.结果 本研究共纳入24篇回顾性队列研究,共1 661例,其中FNS组(FNS治疗)为783例,CS组(CS治疗)为878例.FNS组的术中透视次数(MD=-9.69,95％CI:-11.27～-8.11,P＜0.01)、完全负重时间(MD=-1.69,95％CI:-2.88～-0.50,P＜0.01)、骨折愈合时间(MD=-1.15,95％CI:-1.57～-0.73,P＜0.01)、末次随访 Harris 评分(MD=-1.5,95％CI:2.30～4.59,P＜0.01)及股骨头坏死率(OR=0.48,95％CI:0.26～0.91,P=0.02)优均于 CS 组;但 FNS 组术中出血量(MD=17.72,95％CI:9.88～25.55,P＜0.01)、术区切口长度(MD=0.39,95％CI:0.04～0.73,P=0.03)均大于 CS 组.2 组在手术时间(MD=-3.78,95％CI:-7.95～0.39,P=0.08)、住院总时间(RR=-0.14,95％CI:-0.43～0.14,P=0.32)方面比较,差异无统计学意义.结论 FNS治疗成人股骨颈骨折具有术中透视次数少、完全负重时间早、骨折愈合速度快、髋关节Harris评分高等优点,但与CS相比,术中出血量较多及术区切口较大.
Abstract
Absrtact:Objective To evaluate the efficacy of femoral neck system(FNS)and cannulated screw(CS)in the treatment of femoral neck fracture in adults during perioperative and conjunctional periods.Methods By searching CNKI,Wanfang,VIP,CBM,PubMed,Embase and Cochrane da-tabases,relevant literatures on the efficacy comparison of the two internal fixation regimens were col-lected.Review Manager 5.3 software was used to conduct a meta-analysis of the literature finally in-cluded in the study.Results A total of 24 retrospective cohort studies were included in this study,with a total of 1 661 participants,including 783 participants in the FNS group(FNS treatment)and 878 participants in the CS group(CS treatment).In the FNS group,intraoperative fluoroscopy times(MD=-9.69,95％CI,-11.27 to-8.11,P＜0.01),complete weight-bearing time(MD=-1.69,95％CI,-2.88 to-0.50,P＜0.01),fracture healing time(MD=-1.15,95％CI,-1.57 to-0.73,P＜0.01),Harris score at last follow-up(MD=-1.5,95％CI,2.30 to 4.59,P＜0.01)and femoral head necrosis rate(OR=0.48,95％CI,0.26 to 0.91,P=0.02)were supe-rior in the CS group;however,intraoperative blood loss(MD=17.72,95％CI,9.88 to 25.55,P＜0.01)and incision length(MD=0.39,95％CI,0.04 to 0.73,P=0.03)in the FNS group were higher than those in the CS group.There were no significant differences between the two groups in terms of operation time(MD=-3.78,95％CI,-7.95 to 0.39,P=0.08)and total hospitalization days(RR=-0.14,95％CI,-0.43 to 0.14,P=0.32).Conclusion FNS in the treatment of adult femoral neck fractures has the advantages of less intraoperative fluoroscopy,earlier complete weight-bearing time,faster fracture healing and higher hip Harris score,but compared with CS,it has more intraoperative blood loss and larger incision area.
基金项目
新疆维吾尔自治区自然科学基金(2019D01C244)
维普
万方数据