Wu Haiyi,Liang Longfang,Pei Xinhong.The effect of elastic stable intramedullary nailing single bone fixation in pediatric both bone forearm fractures: A Meta-analysis[J].Journal of Clinical Pediatric Surgery,2019,18(11):941-947.[doi:10.3969/j.issn.1671—6353.2019.11.009]
弹性髓内钉单骨固定治疗儿童前臂双骨折的疗效Meta分析
- Title:
- The effect of elastic stable intramedullary nailing single bone fixation in pediatric both bone forearm fractures: A Meta-analysis
- 分类号:
- R726.8;R683
- 摘要:
- 目的 探讨弹性髓内钉单骨固定治疗儿童前臂双骨折的疗效。方法 检索Pubmed、Embase、Cochrane、维普、万方、CNKI及中国生物医学文献服务系统等数据库公开发表的研究，查阅关于髓内钉单骨与双骨固定治疗儿童前臂双骨折的随机对照研究和病例对照研究（文献的发表时间截至2018年12月）。按照制定的纳入及排除标准，由两位研究者独立对文献进行筛选、资料提取及质量评价。采用RevMan 5.3软件进行Meta分析，比较两种术式术后前臂旋转功能受限、并发症、手术时间、住院费用、骨折愈合时间、石膏固定时间等。结果 本研究最终纳入7篇符合入选标准的文献，其中1篇随机对照研究（仅进行描述，未合并入其他病例对照研究进行统计学分析），6篇病例对照研究；6篇病例对照研究中共纳入302例患儿，其中单骨固定组144例，双骨固定组158例。Meta分析结果显示：单骨固定组术后骨折愈合时间[MD=-0.45，95% CI（-5.02，4.12），P=0.85]、前臂旋转功能受限[OR=1.46，95% CI（0.73，2.89），P=0.28]和术后并发症发生率[OR=0.86，95% CI（0.41，1.78），P=0.68]与双骨固定组无统计学差异。单骨固定组手术时间[MD=-17.76，95% CI（-27.24，-8.27），P=0.0002]和住院费用[MD=-4.24，95% CI（-5.81，-2.66），P<0.00001]与双骨固定组有统计学差异。结论 弹性髓内钉单骨固定治疗儿童前臂双骨折安全、有效且经济。
- Abstract:
- Objective Investigate the efficacy of single-bone fixation by elastic stable intramedullary nailing(ESIN)in the treatment of both-bone forearm fractures in children.Methods PubMed,Embase,Cochrane,VIP,Wanfang,CNKI and China Biomedical Literature Service system were searched electronically to screen the randomized controlled study and case-control study that comparing two surgical methods for both-bone forearm fractures in children.According to the criterion,screening literatures,data extraction and quality assessment were conducted by two reviewers independently.Meta-analysis was performed by using RevMan 5.3 software to evaluate the limitation of forearm rotation function,complications,operation time,hospitalization cost,fracture healing time,gypsum fixation time.Results A total of seven articles were included in the present study,including one randomized controlled trial and six case-control studies,and only six case-control studies were meta-analyzed.Three hundred and two patients were enrolled in the present study,including 144 cases of single bone fixation group and 158cases of both bone fixation group.Meta-analysis showed that the fracture healing time[MD=-0.45,95%CI(-5.02,4.12),P=0.85] and the rotational function of forearm was limited after operation in single bone fixation group[OR=1.46,95%CI(0.73,2.89),P=0.28] and postoperative complications[OR=0.86,95%CI(0.41,1.78),P=0.68] were not statistically different from that of both bone fixation group.Operation time[MD=-17.76,95%CI(-27.24,-8.27),P=0.0002]and hospitalization costs[MD=-4.24,95%CI(-5.81,-2.66),P<0.00001] in single bone fixation group were statistical differences with the both bone fixation group.Conclusion Single-elastic stable intramedullary Nailing fixation is feasible in the treatment of both-bone forearm fracture in children,and it’s safe,effective and economical.
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备注/Memo
收稿日期:2019-01-27。
基金项目:厦门市儿童医院青年科研项目（编号：CHP-2019-YRF-0017）