带袢钢板与锁骨钩钢板治疗肩锁关节脱位效果比较的Meta分析
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摘要
目的系统评价带袢钢板与锁骨钩钢板治疗肩锁关节脱位的效果。方法计算机全面检索The Cochrane Library、PubMed、CNKI、Wanfang、CBM数据库(检索时间从建库至2017年11月),由2位研究员独立完成文献筛选、质量评价和资料提取,并将提取数据采用Review Manager 5.3进行Meta分析。据据治疗方式分为带袢钢板和锁骨钩钢板组。结果最终33篇文献符合纳入标准,共纳入患者1718例。其中带袢钢板组825例,锁骨钩钢板组893例。Meta分析结果显示,带袢钢板组在术后肩关节功能Constant-Murley评分[WMD=6.64,95%CI(3.70,9.57),P <0. 000 01]、肩关节Karlsson分级[OR=3.92,95%CI(2.72,5.66),P <0.000 01]、肩关节活动度恢复[WMD=13.85,95%CI(10.36,17.34),P <0. 000 01]、术中出血量[WMD=-11.38,95%CI(-18.22,-4.54),P=0. 001]方面均优于锁骨钩钢板组,但在手术时间[WMD=1.28,95%CI(-4.38,6.94),P=0.66]方面,两组比较差异无统计学意义(P> 0.05)。结论与锁骨钩钢板内固定治疗肩锁关节脱位比较,带袢钢板内固定能更好地改善肩关节功能,提升肩关节活动度,减少术中出血量,是一种有效、安全的手术方式。
Objective To systematically evaluate the curative effect of Endobutton plate and clavicular hook plate(CHP in the treatment of acromioclavicular joint dislocation. Methods The Cochrane Library, PubMed, CNKI and Wanfang,CBM databases were searched by computer(from the database establishment to November 2017). Two researchers independently screened literature, assessed the methodological quality of literature, and extracted data. Then Meta-analysis was performed with Review Manager 5.3, according to the treatment divided into Endobutton plate group and Clavicular hook plate group. Results In the end, 33 articles met the inclusion criteria, and a total of 1718 patients were included.Among them Endbutton plate group 825 cases, Clavicular hook place group 893 cases. The results of Meta analysis showed that Endobutton plate group were superior to Clavicular hook plate group in the shoulder-joint functional Constant-Murley score [WMD = 6.64, 95%CI(3.70, 9.57), P < 0.000 1], shoulder Karlsson classification [OR = 3.92, 95%CI(2.72,5.66), P < 0.000 01], shoulder mobility recovery [WMD = 13.85,95%CI(10.36,17.34), P < 0.000 1], intraoperative blood loss [WMD = 11.38, 95%CI(-18.22,-4.54), P = 0.001]. However, there was no significant difference between the two groups in the time of operation [WMD = 1.28, 95%CI(-4.38,6.94), P = 0.66]. Conclusion Compared with the internal fixation of clavicular hook plate in the treatment of acromioclavicular joint dislocation, the internal fixation with endobutton plate can better improve the function of shoulder joint, increase the activity of shoulder joint and reduce the intraoperative blood loss, which is an effective and safe operation the way.
Objective To systematically evaluate the curative effect of Endobutton plate and clavicular hook plate(CHP in the treatment of acromioclavicular joint dislocation. Methods The Cochrane Library, PubMed, CNKI and Wanfang,CBM databases were searched by computer(from the database establishment to November 2017). Two researchers independently screened literature, assessed the methodological quality of literature, and extracted data. Then Meta-analysis was performed with Review Manager 5.3, according to the treatment divided into Endobutton plate group and Clavicular hook plate group. Results In the end, 33 articles met the inclusion criteria, and a total of 1718 patients were included.Among them Endbutton plate group 825 cases, Clavicular hook place group 893 cases. The results of Meta analysis showed that Endobutton plate group were superior to Clavicular hook plate group in the shoulder-joint functional Constant-Murley score [WMD = 6.64, 95%CI(3.70, 9.57), P < 0.000 1], shoulder Karlsson classification [OR = 3.92, 95%CI(2.72,5.66), P < 0.000 01], shoulder mobility recovery [WMD = 13.85,95%CI(10.36,17.34), P < 0.000 1], intraoperative blood loss [WMD = 11.38, 95%CI(-18.22,-4.54), P = 0.001]. However, there was no significant difference between the two groups in the time of operation [WMD = 1.28, 95%CI(-4.38,6.94), P = 0.66]. Conclusion Compared with the internal fixation of clavicular hook plate in the treatment of acromioclavicular joint dislocation, the internal fixation with endobutton plate can better improve the function of shoulder joint, increase the activity of shoulder joint and reduce the intraoperative blood loss, which is an effective and safe operation the way.
引文
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[5]黄立军,夏庆福,王伟,等.TossyⅢ型肩锁关节脱位采用锁骨钩钢板与带袢纽扣钢板治疗效果比较[J].现代仪器与医疗,2016,22(4):94-96.
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[7]晋存,计小东,张伟中,等.带袢钢板与锁骨钩钢板治疗TossyⅢ型肩锁关节脱位的临床观察[J].中国中医骨伤科杂志,2014,22(4):21-23.
[8]阮永龙,谢杰,王双利,等.带袢钢板与锁骨钩钢板治疗肩锁关节脱位疗效比较[J].临床骨科杂志,2014,17(4):467-470.
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[13]张隽,夏永法.锁骨钩钢板与Endobutton带袢钢板治疗TossyⅢ型肩锁关节脱位效果比较[J].中国乡村医药,2015,10(10):47-48.
[14]薛华伟,李玉前,王晓东,等.带袢钢板和锁骨钩钢板治疗TossyⅢ型肩锁关节脱位[J].贵阳医学院学报,2013,38(3):286-287.
[15]俞斌,李建.带袢钢板与锁骨钩钢板内固定治疗TossyⅢ型肩锁关节脱位的疗效比较[J].河北联合大学学报:医学版,2012,14(4):513-514.
[16]肖笠,黄巍锋,余文君,等.带袢钢板与锁骨钩钢板治疗RockwoodⅢ型肩锁关节脱位的临床疗效比较[J].广西医科大学学报,2015,32(2):303-305.
[17]左斌,刘建国,符晓川,等.带袢钢板与锁骨钩钢板治疗肩锁关节脱位临床对比分析[J].医学信息,2015,36(36):35-36.
[18]陈高峰,陈福林.带袢钢板治疗急性肩锁关节脱位的疗效观察[J].中国现代医生,2014,52(21):126-128.
[19]宋烜,陈羽,子树明,等.带袢钢板治疗肩锁关节脱位[J].临床骨科杂志,2014,17(1):40-42.
[20]张胜杰.带袢钢板治疗肩锁关节脱位的效果研究[J].医学信息,2017,30(1):271-272.
[21]陈庆元,肖文焕,王天乒,等.改良双Endobutton技术与锁骨钩钢板治疗TOSSYIII型肩锁关节脱位的临床效果分析[J].医药前沿,2013,33(33):85-86.
[22]郑楠,王平,宋国庆,等.钩钢板与带袢钢板治疗肩锁关节脱位的疗效对比观察[J].人民军医,2017,60(2):150-152.
[23]余敏,李雨佳,丑克.喙锁韧带重建与锁骨钩钢板治疗RockwoodⅢ型肩锁关节脱位手术效果比较[J].创伤外科杂志,2016,18(5):277-280.
[24]陆友权,方宣城,李浩.两种手术方式治疗肩锁关节脱位的疗效比较[J].蚌埠医学院学报,2017,42(7):929-931.
[25]梁传兴,黄健,蒋煜青,等.纽扣带袢钢板内固定治疗肩锁关节脱位44例临床观察[J].中国民族民间医药,2015,24(11):45-46.
[26]张金坤,倪善军,缪健荣.纽扣带袢钢板内固定治疗肩锁关节脱位短期临床分析[J].中外医疗,2016,35(26):83-84,87.
[27]费正国.双带袢钢板或锁骨钩钢板用双于治疗RockwoodⅢ型肩锁关节脱位临床比较[J].世界最新医学信息文摘,2017,17(50):168.
[28]陈宏文,李晓声,陈铁柱,等.双带袢钢板与锁骨钩钢板治疗RockwoodⅢ型肩锁关节脱位疗效对比[J].医学临床研究,2015,32(9):1838-1840.
[29]谢伟桐,王虎,钟昌戎,等.双带袢钢板重建喙锁韧带与锁骨钩钢板治疗肩锁关节脱位的疗效比较[J].中国伤残医学,2017,25(10):14-16.
[30]宋健.双切口结合双带袢钢板固定术治疗完全型肩锁关节脱位[J].牡丹江医学院学报,2017,38(4):62-64.
[31]刘志元,朱建国,杨雷.锁骨钩钢板内固定与Endobutton带袢钢板喙锁韧带重建治疗急性不稳定肩锁关节脱位的疗效对比[J].中华卫生应急电子杂志,2016,2(1):21-25.
[32]丁勇.锁骨钩钢板与带袢钛板不同方式治疗肩锁关节脱位的疗效对照评价[J].医药前沿,2017,7(5):177-178.
[33]何文江,黄小顺,刘传芳,等.微创双切口结合双带袢钢板固定技术治疗完全型肩锁关节脱位[J].中国医学创新,2017,14(7):20-23.
[34]梁广权,许鹏雍,陈俊.微创双切口结合双带袢钢板固定技术治疗完全型肩锁关节脱位[J].微创医学,2015,10(5):600-603.
[35]诸力,杨贺杰,赵万军,等.Endobutton袢钢板和锁骨钩钢板治疗新鲜肩锁关节脱位的病例对照研究[J].中国骨伤,2012,25(2):120-123.
[36]陈琼,赵俊强,余冬梅.纽扣钢板与锁骨钩钢板内固定治疗RockwoodⅢ~Ⅴ型肩锁关节脱位的效果比较[J].中国医药导报,2017,14(12):89-92.
[37]林勤.锁骨钩钢板内固定与联合肌腱转位喙锁韧带重建术治疗肩锁关节脱位术后功能效果比较研究[J].中外医学研究,2017,15(32):18-19.
[2]Di Francesco A,Zoccali C,Colafarina O,et al.The use of hook plate in type III and V acromio-clavicular Rockwood dislocations:Clinical and radiological midterm results and MRI evaluation in 42 patients[J].Injury,2011,43(2):147-152.
[3]Zhu L,Yang HJ,Zhao WJ,et al.[Case-control study on endobutton plateorcl avicular hook plate for the repair of acromioclavicular joint dislocations][J].Zhongguo Gu Shang,2012,25(2):120-123.
[4]柯铁,许玮,卢峰,等.3种方法治疗肩锁关节脱位疗效的比较分析[J].福建医药杂志,2015,37(6):134-136.
[5]黄立军,夏庆福,王伟,等.TossyⅢ型肩锁关节脱位采用锁骨钩钢板与带袢纽扣钢板治疗效果比较[J].现代仪器与医疗,2016,22(4):94-96.
[6]陈雪冲,张祝秋,刘小勇,等.TossyⅢ型肩锁关节脱位采用CHP与双Endobutton带袢钢板治疗的临床疗效比较[J].颈腰痛杂志,2015,36(5):424-426.
[7]晋存,计小东,张伟中,等.带袢钢板与锁骨钩钢板治疗TossyⅢ型肩锁关节脱位的临床观察[J].中国中医骨伤科杂志,2014,22(4):21-23.
[8]阮永龙,谢杰,王双利,等.带袢钢板与锁骨钩钢板治疗肩锁关节脱位疗效比较[J].临床骨科杂志,2014,17(4):467-470.
[9]郑伟浩.带袢钢板治疗TossyⅢ型肩锁关节脱位的临床研究与应用[D].长春:长春中医药大学,2013.
[10]崔继君,王哲,张胜杰,等.带袢钢板治疗肩锁关节脱位的临床研究[J].湖南师范大学学报:医学版,2017,14(2):106-109.
[11]范国崇,吴继国,吕世乾,等.切口ORTHOCORD线内固定、锁骨钩钢板、关节镜下带袢钢板治疗肩锁关节脱位RockwoodⅢ型的临床对比研究[J].医学综述,2016,22(2):383-385,388.
[12]李成,邓伟捷,万雷,等.锁骨钩钢板和双Endobutton带袢钢板治疗TossyⅢ型肩锁关节脱位疗效比较[J].中国民族民间医药,2015,5(5):125-126.
[13]张隽,夏永法.锁骨钩钢板与Endobutton带袢钢板治疗TossyⅢ型肩锁关节脱位效果比较[J].中国乡村医药,2015,10(10):47-48.
[14]薛华伟,李玉前,王晓东,等.带袢钢板和锁骨钩钢板治疗TossyⅢ型肩锁关节脱位[J].贵阳医学院学报,2013,38(3):286-287.
[15]俞斌,李建.带袢钢板与锁骨钩钢板内固定治疗TossyⅢ型肩锁关节脱位的疗效比较[J].河北联合大学学报:医学版,2012,14(4):513-514.
[16]肖笠,黄巍锋,余文君,等.带袢钢板与锁骨钩钢板治疗RockwoodⅢ型肩锁关节脱位的临床疗效比较[J].广西医科大学学报,2015,32(2):303-305.
[17]左斌,刘建国,符晓川,等.带袢钢板与锁骨钩钢板治疗肩锁关节脱位临床对比分析[J].医学信息,2015,36(36):35-36.
[18]陈高峰,陈福林.带袢钢板治疗急性肩锁关节脱位的疗效观察[J].中国现代医生,2014,52(21):126-128.
[19]宋烜,陈羽,子树明,等.带袢钢板治疗肩锁关节脱位[J].临床骨科杂志,2014,17(1):40-42.
[20]张胜杰.带袢钢板治疗肩锁关节脱位的效果研究[J].医学信息,2017,30(1):271-272.
[21]陈庆元,肖文焕,王天乒,等.改良双Endobutton技术与锁骨钩钢板治疗TOSSYIII型肩锁关节脱位的临床效果分析[J].医药前沿,2013,33(33):85-86.
[22]郑楠,王平,宋国庆,等.钩钢板与带袢钢板治疗肩锁关节脱位的疗效对比观察[J].人民军医,2017,60(2):150-152.
[23]余敏,李雨佳,丑克.喙锁韧带重建与锁骨钩钢板治疗RockwoodⅢ型肩锁关节脱位手术效果比较[J].创伤外科杂志,2016,18(5):277-280.
[24]陆友权,方宣城,李浩.两种手术方式治疗肩锁关节脱位的疗效比较[J].蚌埠医学院学报,2017,42(7):929-931.
[25]梁传兴,黄健,蒋煜青,等.纽扣带袢钢板内固定治疗肩锁关节脱位44例临床观察[J].中国民族民间医药,2015,24(11):45-46.
[26]张金坤,倪善军,缪健荣.纽扣带袢钢板内固定治疗肩锁关节脱位短期临床分析[J].中外医疗,2016,35(26):83-84,87.
[27]费正国.双带袢钢板或锁骨钩钢板用双于治疗RockwoodⅢ型肩锁关节脱位临床比较[J].世界最新医学信息文摘,2017,17(50):168.
[28]陈宏文,李晓声,陈铁柱,等.双带袢钢板与锁骨钩钢板治疗RockwoodⅢ型肩锁关节脱位疗效对比[J].医学临床研究,2015,32(9):1838-1840.
[29]谢伟桐,王虎,钟昌戎,等.双带袢钢板重建喙锁韧带与锁骨钩钢板治疗肩锁关节脱位的疗效比较[J].中国伤残医学,2017,25(10):14-16.
[30]宋健.双切口结合双带袢钢板固定术治疗完全型肩锁关节脱位[J].牡丹江医学院学报,2017,38(4):62-64.
[31]刘志元,朱建国,杨雷.锁骨钩钢板内固定与Endobutton带袢钢板喙锁韧带重建治疗急性不稳定肩锁关节脱位的疗效对比[J].中华卫生应急电子杂志,2016,2(1):21-25.
[32]丁勇.锁骨钩钢板与带袢钛板不同方式治疗肩锁关节脱位的疗效对照评价[J].医药前沿,2017,7(5):177-178.
[33]何文江,黄小顺,刘传芳,等.微创双切口结合双带袢钢板固定技术治疗完全型肩锁关节脱位[J].中国医学创新,2017,14(7):20-23.
[34]梁广权,许鹏雍,陈俊.微创双切口结合双带袢钢板固定技术治疗完全型肩锁关节脱位[J].微创医学,2015,10(5):600-603.
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