Clinical efficacy of ulnar distal diaphyseal osteotomy and metaphyseal osteotomy in the treatment of ulnar impaction syndrome:a Meta analysis
Objective Ulnar shortening osteotomy(USO)is a major surgical treatment of ulnar impaction syndrome(UIS),which is mainly divided into distal diaphyseal and metaphyseal ulnar shortening osteotomy according to the location of the amputation.Both procedures have been shown to be safe and reliable,but there is no uniform clinical criteria for optimal site selection.Therefore,we systematically evaluated the clinical efficacy comparing the treatment of distal metaphyseal ulnar shortening osteotomy(DMUSO)with distal diaphyseal ulnar shortening osteotomy(DDUSO)for ulnar impaction syndrome.Methods PubMed,EMBASE,Cochrane Library,Wanfang,Weip and CNKI were systematically searched for reports published before March 2023.The controlled trial and retrospective study of distal diaphyseal and metaphyseal ulnar shortening osteotomy for the treatment of ulnar impingement syndrome were collected according to inclusion and exclusion criteria.The retrieved literatures were screened and evaluated.The data were extracted,graphed and analyzed using RevMan5.3.Results Seven literatures with 219 cases(99 in metaphyseal and 120 in diaphyseal osteotomy)were included in the retrospective study,4 in English and 3 in Chinese.Meta analyis showed that the treatment of DMUSO was better on operation time[MD=-19.60,95%CI(-35.24,-3.96),P<0.05],fracture healing time[MD=-0.88,95%CI(-1.14,-0.62),P<0.05],grip strength[MD=3.07,95%CI(1.63,4.50),P<0.05],VAS pain score[MD=-0.87,95%CI(-1.01,-0.73),P<0.05],wrist function score[MD=8.53,95%CI(5.52,11.50),P<0.05]and wrist rotational motion[MD=6.4,95%CI(2.98,9.86),P<0.05].In terms of adverse reaction and wrist range motion(flexion,extension,adduction and abduction),there was no statistically significant difference between the metaphyseal osteotomy group and diaphyseal osteotomy group(P>0.05).Conclusions Compared with ulnar distal diaphyseal osteotomy,the metaphyseal osteotomy will reduce the operation time,promote bone healing,relieve pain,improve the function of wrist joint,and increase the wrist rotational motion.It can be used as an alternative treatment and is worthy of clinical application.
NETL
NSTL
万方数据
