1、弹性髓内钉与钢板内固定修复前臂骨折疗效与安全性的 Meta 分析刘国庆 1，王文己 1，2 ，时红萍 1，孙 凯 3 1 兰州大学第一临床医学院，甘肃省兰州市 730000； 2 兰州大学第一医院，甘肃省兰州市 730000； 3 天津医科大学，天津市 300000)Therapeutic effect and safety of elastic intramedullary nail versus plate fixation in repair of fracture of forearm: a meta-analysisLiu Guo-qing1, Wang Wen-ji 1, 2, S
2、hi Hong-ping1, Sun Kai31 First Clinical Medicine College, Lanzhou University, Lanzhou 730000, Gansu Province, China; 2 First Hospital, Lanzhou University, Lanzhou 730000, Gansu Province, China; 3 Tianjin Medical University, Tianjin 300000, China摘要 背景：随着微创技术的发展，越来越多的前臂骨折尤其儿童前臂骨折采用弹性髓内钉技术内固定，近几年也有应用于大
3、龄儿童，甚至成年人的文献报道，特别是对于开放性骨折和不稳定性骨折，应用该技术已取得良好的疗效。目的：采用循证医学方法评价弹性髓内钉及钢板内固定修复前臂骨折的临床疗效和安全性。方法：计算机检索 PubMed、 EMBASE、Cochrane Library 和中国生物医学文献数据库、中文科技期刊全文数据库、中国期刊全文数据库、万方数据库，并辅以其他检索。按照Cochrane 系统评价方法评价纳入研究的质量，采用 RevMan 5.2 软件进行统计分析。结果与结论：共纳入 7 个随机对照试验，共 468 例患者。Meta 分析结果显示，弹性髓内钉治疗前臂骨折与钢板内固定相比可提高总有效率(P 0.
4、000 1)，缩短骨折 X 射线愈合时间(P 0.000 01)，缩短住院时间(P 0.000 01)。在不良反应方面，弹性髓内钉组再骨折(P=0.03)、内固定物断裂(P =0.03)发生率明显减少。提示与钢板内固定相比，应用弹性髓内钉内固定修复前臂骨折能够提高总有效率，缩短骨折 X 射线愈合时间及住院时间，同时能够减少再骨折及内固定物断裂等并发症的发生。中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程全文链接：关键词 ： 植入物； 骨植入物； 前臂骨折； 弹性髓内钉； 钢板内固定； Meta 分析； Abstract： BACKGROUND:
5、With the development of minimally invasive technique, more and more forearm fracture, especially in children, was treated by elastic stable intramedullary nailing. Recently, elastic stable intramedullary nailing was also used in elder children, even adults. In particular, this technique has obtained
6、 good curative effects for open fracture and unstable fracture. OBJECTIVE: To evaluate the clinical effectiveness and safety of elastic intramedullary nail and plate fixation for double fracture of forearm using evidence-based medicine. METHODS: We retrieved PubMed, Embase, Cochrane Library, China B
7、iology Medicine, VIP, China National Knowledge Infrastructure, WanFang, and other electronic databases. The quality of the included studies was assessed using Cochrane Systematic Review. The analysis was performed using RevMan 5.2 software.RESULTS AND CONCLUSION: A total of 7 randomized controlled t
8、rials involving 468 cases were included. The results of meta-analyses showed that compared with plate fixation group, effective rate was higher in the titanium elastic nail group (P 0.000 1), the time of fracture healing was shorter (P 0.000 01), and the hospitalization time was shorter (P 0.000 01)
9、. In the aspect of adverse reactions, incidence of refracture (P=0.03) and breakage of internal fixation (P=0.03) was significantly lower. These indicated that compared with plate fixation, titanium elastic nail can improve the total effective rate, shorten the time of fracture healing on X-ray and
10、the hospitalization time, at the same time, can effectively reduce the complications of refracture and breakage of internal fixation.中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程全文链接：Key words： internal fixators; forearm; fractures, bone; meta-analysis; 中图分类号: R318 通讯作者: 王文己，硕士生导师，博士，主任医师，副教授，兰州大学
11、第一临床医学院，甘肃省兰州市 730000；兰州大学第一医院，甘肃省兰州市 730000 作者简介: 刘国庆，男，1984 年生，山东省菏泽市人，在读硕士，主治医师，主要从事骨创伤、脊柱及关节疾病的研究。引用本文: 刘国庆,王文己 ,时红萍等 . 弹性髓内钉与钢板内固定修复前臂骨折疗效与安全性的 Meta 分析J. 中国组织工程研究, 2014, 18(26): 4248-4253. Liu Guo-qing,Wang Wen-ji,Shi Hong-ping et al. Therapeutic effect and safety of elastic intramedullary nail versus plate fixation in repair of fracture of forearm: a meta-analysisJ. Chinese Journal of Tissue Engineering Research, 2014, 18(26): 4248-4253.
