Surgical versus non-surgical treatment of type Ⅲ acromioclavicular dislocation:A meta-analysis
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[目的]系统评价手术与非手术治疗Rockwood Ⅲ型肩锁关节脱位的临床疗效.[方法]检索建库至2022年6月Co-chrane Library、PubMed、Web of science、EMBASE、中国知网数据库、万方数据库及中国生物医学数据库,收集比较手术与非手术治疗Rockwood Ⅲ型肩锁关节脱位的临床研究.采用RevMan5.2软件进行荟萃分析.[结果]共纳入17篇文献,1006例患者.荟萃分析结果显示:手术组肩锁关节炎发生率(OR=6.01,95％CI2.16～16.68,P=0.0006)、感染发生率(OR=5.92,95％CI 1.35～22.91,P=0.02)、异位骨化发生率(OR=1.98,95％CI1.18～3.32,P=0.009)均显著高于保守组.保守组结局功能优良率(OR=1.75,95％CI 1.19～2.58,P＜0.05)、Constant 评分显著优于手术组(WMD=1.79,95％CI 1.14～2.43,P＜0.05).保守组和手术组并发症发生率(OR=1.73,95％CI0.65～4.63,P=0.27)、肩关节疼痛(OR=1.23,95％CI0.61～2.47,P=0.57)、锁骨外侧骨溶解发生率(OR=1.31,95％CI0.39～4.38,P=0.66)的差异均无统计学意义.[结论]在并发症、疼痛、肩锁关节溶骨等方面手术和保守治疗没有差别,但是在感染、肩锁关节炎、异位骨化、结局功能优良率、Constant评分等方面,保守治疗有明显优势.
[Objective]To systematically evaluate the clinical efficacy of surgical versus non-surgical treatment of Rockwood type Ⅲacromioclavicular dislocation.[Methods]The literatures regarding comparison of surgical versus non-surgical treatment of Rockwood typeⅢ acromioclavicular dislocation were searched from the databases,including Cochrane Library,PubMed,Web of science,EMBASE,CNKI database,Wanfang database and China Biomedical Database until June 2022,and then a meta-analysis was performed using RevMan 5.2 software.[Results]A total of 17 articles involving 1 006 patients were included.As results of meta-analysis,the surgical group was signifi-cantly greater than the non-surgical group in terms of incidence of acromioclavicular arthritis(OR=6.01,95％CI 2.16～16.68,P=0.0006),in-fection(OR=5.92,95％CI 1.35～22.91,P=0.02)and ectopic ossification(OR=1.98,95％CI 1.18～3.32,P=0.009),while the non-surgical group was significantly better than the surgical group in terms of functional excellence rate(OR=1.75,95％CI 1.19～2.58)and Constant score(WMD=1.79,95％CI 1.14～2.43,P＜0.05).However,there was no significant difference between the two groups in terms of incidence of complications(OR=1.73,95％CI 0.65～4.63,P=0.27),shoulder pain(OR=1.23,95％CI 0.61～2.47,P=0.57)and lateral clavicular osteoly-sis(OR=1.31,95％CI 0.39～4.38,P=0.66).[Conclusion]There is no difference between surgical treatment and non-surgical treatment in terms of complications,pain and osteolysis of acromioclavicular joint,but non-surgical treatment has obvious advantages over the surgical treatment in terms of infection,acromioclavicular arthritis,ectopic ossification,outcome function and constant score.
Rockwood type Ⅲ acromioclavicular dislocationsurgical treatmentnon-surgical treatmentmeta-analysis
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NSTL
万方数据
