股骨颈骨折动力交叉钉与其他固定的荟萃分析
Journal: Basic Medical Theory Research DOI: 10.12238/bmtr.v6i5.10055
Abstract
目的：综合评价股骨颈动力交叉钉系统固定与其他固定方式治疗股骨颈骨折的效果。方法：计算机检索PubMed、Embase、Cochrane Library、Web of science、CNKI、万方、维普数据库,同时手动检索中华医学会系列期刊的相关文献,检索时间为自建库至2022年5月。汇总所有关于股骨颈动力交叉钉系统固定与其他内固定治疗股骨颈骨折的对照研究,纳入条件相符合的文章,并逐一对纳入研究进行严格评价的文献质量评价。采取RevMan 5.4软件进行本次的Meta分析。纳入的指标包含手术时长、住院时长、术中出血量、术中透视次数、手术切口长度、骨折愈合时间、末次Harris评分、股骨头坏死发生率、骨不连发生率以及股骨颈短缩发生率。结果：共纳入23篇文献,其中中文文献14篇,英文文献9篇,纳入研究文献共1036例股骨颈骨折患者,其中476例使用股骨颈动力交叉钉系统固定,560例采用其他内固定方式。Meta分析结果显示,与其他内固定方式相比,股骨颈动力交叉钉系统具有骨折愈合时间短
[SMD=-0.46,95%CI(-0.63,-0.29),P＜0.00001]、末次Harris评分高[SMD=0.62,95%CI(0.48,0.77),P＜0.00001]、股骨颈短缩发生率低[OR=0.45,95%CI(0.26,0.77),P=0.003],但术中出血量多[SMD=0.32,95%CI(0.15,0.48),P=0.0001],在住院时长[SMD=0.02,95%CI(–0.13,-0.17),P=0.82]、股骨坏死发生率[SMD=0.52,95%CI(0.27,1.02),P=0.06]、骨不连发生率[OR=0.55,95%CI(0.30,1.00),P=0.05]方面二者无差异。手术时长、术中透视次数由于异质性较大,所以采用描述性分析,需进一步的研究证明差异性。手术切口长度由于研究未能提供详细的数据,所以也采用描述性分析,需进一步的研究证明差异性。结论：与其他内固定相比,股骨颈动力交叉钉系统固定骨折愈合时间短、末次Harris评分高、股骨颈短缩发生率低,但术中出血量多,在住院时长、股骨坏死发生率、骨不连发生率方面无差异。
Keywords
股骨颈骨折；股骨颈动力交叉钉系统固定；Meta分析
Funding
广西壮族自治区科技重大专项(医疗机构中药制剂开发)桂科AA23023035-2。
Full Text
PDF - Viewed/Downloaded: 0 TimesReferences
[1] 张长青,张英泽,余斌,等.成人股骨颈骨折诊治指南[J].中华创伤骨科杂志,2018,20(11):921-928.
[2] Wu Haiyang,Li Yuqiao,Tong Linjian,等.Worldwide research tendency and hotspots on hip fracture:a20-year bibliometri canalysis[J].Archivesof osteoporosis,2021,(1):73.
[3] 许新忠,常菁,余水生,等.股骨颈系统固定治疗股骨颈骨折的近期疗效分析[J].中华创伤骨科杂志,2020,22(7):624-627.
[4] 熊巍,易敏,龙成,等.股骨颈动力交叉钉系统与倒三角形空心螺钉固定治疗成人股骨颈骨折的疗效比较[J].中华创伤骨科杂志,2021,23(9):748-753.
[5] Slobogean Gerard-P,Sprague Sheila,Bzovsky Sofia,等. Fixation using alternative implants for the treatment of hip fractures(FAITH-2):design and rationale for a pilot multicentre2 × 2 factorial randomized controlled trial in young femoral neck fracture patients[J].Pilot and feasibility studies, 2019:70.
[6] Zhang Lei-Lei,Zhang Ying,Ma Xianghao,等.Multiple cann ulated screws vs. dynamic hip screws for femoral neck fractu res:A meta-analysis[J].Der Orthopade,2017,(11):954-962.
[7] Mukherjee P,Ashworth M-J.A new device to treat intra -capsular fracture neck of femur non-union.[J]. Strategies in trauma and limbreconstruction,2010,(3):159-62.
[8] 张华亮,曾剑文,谢建军,等.两种手术方法治疗青壮年股骨颈骨折的疗效分析[J].中国矫形外科杂志,2014,22(24):2215-2218.
[9] LiJia,Zhao Zhe,Yin Pengbin,等.Comparison of three diff erent internal fixation implants in treatment of femoral neck fracture-a finite element analysis.[Z],2019:76.
[10] Shen Min,Wang Chen,Chen Hui,等. An update on the Pauwels classification.[J]. Journal of orthopaedic surgery and research,2016,(1):161.
[11] Schopper Clemens,Zderic Ivan,Menze Johanna,等.Higher stability and more predictive fixation with the Femoral Neck System versus Hansson Pins in femoral neck fractures Pauwels II.[J].Journal of orthopaedic translation,2020:88-95.
[12] Stoffel Karl,Zderic Ivan,Gras Florian,等.Biomechanic al Evaluation of the Femoral Neck System in Unstable Pauwels III Femoral Neck Fractures: A Comparison with the Dynamic Hip Screw and Cannulated Screws[J].Journal of orthopaedic trauma, 2017,(3):131-137.
[13] 杜兵,马腾,路遥,等.新型股骨颈内固定系统与3枚空心钉加内侧钢板固定青壮年PauwelsⅢ型股骨颈骨折的有限元分析[J].医用生物力学,2021,36(S1):217.
[14] 邓思煜,谭绍林,严国华,等.股骨颈动力交叉钉系统与动力髋螺钉治疗PauwelsⅡ型股骨颈骨折的有限元分析[J].中华实验外科杂志,2021,38(10):1959-1959.
[15] Hu Huaijian,Cheng Jingbo,Feng Mingli,等.Clinical out come of femoral neck system versus cannulated compression screws for fixation of femoral neck fracture in younger patie nts.[J]. Journal of orthopaedic surgery and research, 2021, (1):370.
[16] Zhou Xiao-Qiang,Li Zhi-Qiang,Xu Ren-Jie,等.Comparis on of Early Clinical Results for Femoral Neck System and Cannulated Screws in the Treatment of Unstable Femoral Neck Fractures[J].Orthopaedic surgery,2021,(6):1802-1809.
[17] Marcel Niemann,Karl F Braun,Sufian S Ahmad, et al. Comparing Perioperative Outcome Measures of the Dynamic Hip Screw and the Femoral Neck System[J].Medicina (kaunas, Lithu ania),2022,(3).
[18] Tang Yunfeng,Zhang Zhen,Wang Limin,等. Femoral neck system versus inverted cannulated cancellous screw for the treatment of femoral neck fractures in adults: a preliminary comparative study.[J].Journal of orthopaedic surgery and research,2021,(1):504.
[19] Yoshiya Nibe,Tomohiro Matsumura,Tsuneari Takahashi, et al. A comparison between the femoral neck system and other implants for elderly patients with femoral neck fracture: A preliminary report of a newly developed implant.[J]. Journal of Orthopaedic Science:Official Journal of the Japanese Orth opaedic Association,2021.
[20] Vazquez Oscar,Gamulin Axel,Hannouche Didier,等.Osteo synthesis of non-displaced femoral neck fractures in the elderly population using the femoral neck system (FNS): short -term clinical and radiological outcomes[J].Journal of orthop aedic surgery and research,2021,(1):477.
[21] Xiangyu Xu,Jixing Fan,Fang Zhou, et al. Comparison of femoral neck system to multiple cancellous screws and dynamic hip screws in the treatment of femoral neck fractures.[J]. Injury,2022.
[22] He Changjun,Lu Yao,Wang Qian,等. Comparison of the clinical efficacy of a femoral neck system versus cannulated screws in the treatment of femoral neck fracture in young adults[J].BMC musculoskeletal disorders,2021,(1):994.
[23] Zhang Ya-Zhong,Lin Yan,Li Chao,等.A Comparative Anal ysis of Femoral Neck System and Three Cannulated Screws Fixa tion in the Treatment of Femoral Neck Fractures: A Six-Month Follow-Up[J].Orthopaedic surgery,2022,(4):686-693.
[24] 张彬,张一,佘荣峰,等.加速康复外科理念下应用股骨颈系统和空心螺钉治疗股骨颈骨折的近期疗效比较[J].骨科临床与研究杂志,2022,7(1):15-21.
[25] 葛双雷,王雪飞,胡国东,等.股骨颈动力交叉钉系统治疗中青年PauwelsⅡ型股骨颈骨折临床价值[J].中国骨与关节杂志,2022,11(4):255-260.
[26] 赵耀,程文丹,许新忠,等.股骨颈动力交叉钉系统和空心加压螺钉治疗股骨颈骨折近期疗效分析[J].生物骨科材料与临床研究,2022,19(2):67-72.
[27] 郑宏瑞,张文杰,王云华,等.股骨颈动力交叉钉系统联合富血小板血浆治疗股骨颈骨折[J].中国组织工程研究:1-6.
[28] 王磊,李佳.在高海拔地区应用股骨颈交叉系统内固定治疗股骨颈骨折[J].中国组织工程研究,2022,26(18):2844-2848.
[29] 许翔宇,周方,田耘,等.股骨颈动力交叉钉系统与动力髋螺钉固定治疗股骨颈骨折的早期疗效比较[J].中华创伤骨科杂志,2021,23(9):754-760.
[30] 任程,马腾,李明,等.股骨颈动力交叉钉系统固定治疗中青年股骨颈骨折的近期疗效评价[J].中华创伤骨科杂志,2021,23(9):769-774.
[31] 严才平,王星宽,向超,等.股骨颈动力交叉钉系统与空心加压螺钉治疗中青年股骨颈骨折的疗效比较[J].中国修复重建外科杂志,2021,35(10):1286-1292.
[32] 高培栗,罗刚,倪卫东.股骨颈系统与空心拉力螺钉治疗股骨颈骨折近期临床疗效比较[J].重庆医科大学学报,2022,47(4):427-432.
[33] 杨亚军,马涛,张小钰,等.股骨颈动力交叉钉系统治疗股骨颈骨折近期疗效[J].中国修复重建外科杂志,2021,35(5):539-543.
[34] 杨家赵,周雪锋,李黎,等.股骨颈动力交叉钉系统和倒三角空心钉治疗PauwelsⅢ型股骨颈骨折疗效比较[J].中国修复重建外科杂志,2021,35(9):1111-1118.
[35] 杨家赵,周雪锋,朱万博,等.股骨颈动力交叉钉系统与空心螺钉固定治疗青壮年股骨颈骨折的近期疗效比较[J].中华创伤骨科杂志,2021,23(9):761-768.
[36] 何昌军,马腾,任程,等.股骨颈动力交叉钉系统与空心螺钉治疗中青年股骨颈骨折的疗效比较[J].中华创伤杂志,2022,38(3):253-259.
[37] Huaijian Hu,Jingbo Cheng,Mingli Feng, et al. Clinical outcome of femoral neck system versus cannulated compression screws for fixation of femoral neck fracture in younger patie nts[J]. Journal of Orthopaedic Surgery and Research, 2021, 16(1).
[38] Xiao-Qiang Zhou,Zhi-Qiang Li,Ren-Jie Xu,etal.Compa rison of Early Clinical Results for Femoral Neck System and Cannulated Screws in the Treatment of Unstable Femoral Neck Fractures[J].Orthopaedic Surgery,2021,13(6):1802-1809.
[39] 盛东.股骨颈动力交叉钉系统和倒三角空心钉治疗中青年PauwelsⅢ型股骨颈骨折疗效比较[D].江苏:扬州大学,2023.
[40] 周方.股骨颈骨折治疗的热点与创新[J].中华创伤骨科杂志,2021,23(9):742-747.
[2] Wu Haiyang,Li Yuqiao,Tong Linjian,等.Worldwide research tendency and hotspots on hip fracture:a20-year bibliometri canalysis[J].Archivesof osteoporosis,2021,(1):73.
[3] 许新忠,常菁,余水生,等.股骨颈系统固定治疗股骨颈骨折的近期疗效分析[J].中华创伤骨科杂志,2020,22(7):624-627.
[4] 熊巍,易敏,龙成,等.股骨颈动力交叉钉系统与倒三角形空心螺钉固定治疗成人股骨颈骨折的疗效比较[J].中华创伤骨科杂志,2021,23(9):748-753.
[5] Slobogean Gerard-P,Sprague Sheila,Bzovsky Sofia,等. Fixation using alternative implants for the treatment of hip fractures(FAITH-2):design and rationale for a pilot multicentre2 × 2 factorial randomized controlled trial in young femoral neck fracture patients[J].Pilot and feasibility studies, 2019:70.
[6] Zhang Lei-Lei,Zhang Ying,Ma Xianghao,等.Multiple cann ulated screws vs. dynamic hip screws for femoral neck fractu res:A meta-analysis[J].Der Orthopade,2017,(11):954-962.
[7] Mukherjee P,Ashworth M-J.A new device to treat intra -capsular fracture neck of femur non-union.[J]. Strategies in trauma and limbreconstruction,2010,(3):159-62.
[8] 张华亮,曾剑文,谢建军,等.两种手术方法治疗青壮年股骨颈骨折的疗效分析[J].中国矫形外科杂志,2014,22(24):2215-2218.
[9] LiJia,Zhao Zhe,Yin Pengbin,等.Comparison of three diff erent internal fixation implants in treatment of femoral neck fracture-a finite element analysis.[Z],2019:76.
[10] Shen Min,Wang Chen,Chen Hui,等. An update on the Pauwels classification.[J]. Journal of orthopaedic surgery and research,2016,(1):161.
[11] Schopper Clemens,Zderic Ivan,Menze Johanna,等.Higher stability and more predictive fixation with the Femoral Neck System versus Hansson Pins in femoral neck fractures Pauwels II.[J].Journal of orthopaedic translation,2020:88-95.
[12] Stoffel Karl,Zderic Ivan,Gras Florian,等.Biomechanic al Evaluation of the Femoral Neck System in Unstable Pauwels III Femoral Neck Fractures: A Comparison with the Dynamic Hip Screw and Cannulated Screws[J].Journal of orthopaedic trauma, 2017,(3):131-137.
[13] 杜兵,马腾,路遥,等.新型股骨颈内固定系统与3枚空心钉加内侧钢板固定青壮年PauwelsⅢ型股骨颈骨折的有限元分析[J].医用生物力学,2021,36(S1):217.
[14] 邓思煜,谭绍林,严国华,等.股骨颈动力交叉钉系统与动力髋螺钉治疗PauwelsⅡ型股骨颈骨折的有限元分析[J].中华实验外科杂志,2021,38(10):1959-1959.
[15] Hu Huaijian,Cheng Jingbo,Feng Mingli,等.Clinical out come of femoral neck system versus cannulated compression screws for fixation of femoral neck fracture in younger patie nts.[J]. Journal of orthopaedic surgery and research, 2021, (1):370.
[16] Zhou Xiao-Qiang,Li Zhi-Qiang,Xu Ren-Jie,等.Comparis on of Early Clinical Results for Femoral Neck System and Cannulated Screws in the Treatment of Unstable Femoral Neck Fractures[J].Orthopaedic surgery,2021,(6):1802-1809.
[17] Marcel Niemann,Karl F Braun,Sufian S Ahmad, et al. Comparing Perioperative Outcome Measures of the Dynamic Hip Screw and the Femoral Neck System[J].Medicina (kaunas, Lithu ania),2022,(3).
[18] Tang Yunfeng,Zhang Zhen,Wang Limin,等. Femoral neck system versus inverted cannulated cancellous screw for the treatment of femoral neck fractures in adults: a preliminary comparative study.[J].Journal of orthopaedic surgery and research,2021,(1):504.
[19] Yoshiya Nibe,Tomohiro Matsumura,Tsuneari Takahashi, et al. A comparison between the femoral neck system and other implants for elderly patients with femoral neck fracture: A preliminary report of a newly developed implant.[J]. Journal of Orthopaedic Science:Official Journal of the Japanese Orth opaedic Association,2021.
[20] Vazquez Oscar,Gamulin Axel,Hannouche Didier,等.Osteo synthesis of non-displaced femoral neck fractures in the elderly population using the femoral neck system (FNS): short -term clinical and radiological outcomes[J].Journal of orthop aedic surgery and research,2021,(1):477.
[21] Xiangyu Xu,Jixing Fan,Fang Zhou, et al. Comparison of femoral neck system to multiple cancellous screws and dynamic hip screws in the treatment of femoral neck fractures.[J]. Injury,2022.
[22] He Changjun,Lu Yao,Wang Qian,等. Comparison of the clinical efficacy of a femoral neck system versus cannulated screws in the treatment of femoral neck fracture in young adults[J].BMC musculoskeletal disorders,2021,(1):994.
[23] Zhang Ya-Zhong,Lin Yan,Li Chao,等.A Comparative Anal ysis of Femoral Neck System and Three Cannulated Screws Fixa tion in the Treatment of Femoral Neck Fractures: A Six-Month Follow-Up[J].Orthopaedic surgery,2022,(4):686-693.
[24] 张彬,张一,佘荣峰,等.加速康复外科理念下应用股骨颈系统和空心螺钉治疗股骨颈骨折的近期疗效比较[J].骨科临床与研究杂志,2022,7(1):15-21.
[25] 葛双雷,王雪飞,胡国东,等.股骨颈动力交叉钉系统治疗中青年PauwelsⅡ型股骨颈骨折临床价值[J].中国骨与关节杂志,2022,11(4):255-260.
[26] 赵耀,程文丹,许新忠,等.股骨颈动力交叉钉系统和空心加压螺钉治疗股骨颈骨折近期疗效分析[J].生物骨科材料与临床研究,2022,19(2):67-72.
[27] 郑宏瑞,张文杰,王云华,等.股骨颈动力交叉钉系统联合富血小板血浆治疗股骨颈骨折[J].中国组织工程研究:1-6.
[28] 王磊,李佳.在高海拔地区应用股骨颈交叉系统内固定治疗股骨颈骨折[J].中国组织工程研究,2022,26(18):2844-2848.
[29] 许翔宇,周方,田耘,等.股骨颈动力交叉钉系统与动力髋螺钉固定治疗股骨颈骨折的早期疗效比较[J].中华创伤骨科杂志,2021,23(9):754-760.
[30] 任程,马腾,李明,等.股骨颈动力交叉钉系统固定治疗中青年股骨颈骨折的近期疗效评价[J].中华创伤骨科杂志,2021,23(9):769-774.
[31] 严才平,王星宽,向超,等.股骨颈动力交叉钉系统与空心加压螺钉治疗中青年股骨颈骨折的疗效比较[J].中国修复重建外科杂志,2021,35(10):1286-1292.
[32] 高培栗,罗刚,倪卫东.股骨颈系统与空心拉力螺钉治疗股骨颈骨折近期临床疗效比较[J].重庆医科大学学报,2022,47(4):427-432.
[33] 杨亚军,马涛,张小钰,等.股骨颈动力交叉钉系统治疗股骨颈骨折近期疗效[J].中国修复重建外科杂志,2021,35(5):539-543.
[34] 杨家赵,周雪锋,李黎,等.股骨颈动力交叉钉系统和倒三角空心钉治疗PauwelsⅢ型股骨颈骨折疗效比较[J].中国修复重建外科杂志,2021,35(9):1111-1118.
[35] 杨家赵,周雪锋,朱万博,等.股骨颈动力交叉钉系统与空心螺钉固定治疗青壮年股骨颈骨折的近期疗效比较[J].中华创伤骨科杂志,2021,23(9):761-768.
[36] 何昌军,马腾,任程,等.股骨颈动力交叉钉系统与空心螺钉治疗中青年股骨颈骨折的疗效比较[J].中华创伤杂志,2022,38(3):253-259.
[37] Huaijian Hu,Jingbo Cheng,Mingli Feng, et al. Clinical outcome of femoral neck system versus cannulated compression screws for fixation of femoral neck fracture in younger patie nts[J]. Journal of Orthopaedic Surgery and Research, 2021, 16(1).
[38] Xiao-Qiang Zhou,Zhi-Qiang Li,Ren-Jie Xu,etal.Compa rison of Early Clinical Results for Femoral Neck System and Cannulated Screws in the Treatment of Unstable Femoral Neck Fractures[J].Orthopaedic Surgery,2021,13(6):1802-1809.
[39] 盛东.股骨颈动力交叉钉系统和倒三角空心钉治疗中青年PauwelsⅢ型股骨颈骨折疗效比较[D].江苏:扬州大学,2023.
[40] 周方.股骨颈骨折治疗的热点与创新[J].中华创伤骨科杂志,2021,23(9):742-747.
Copyright © 2024 宗驿, 丰哲, 莫万瑜, 袁阳, 周天豪, 邹建斌
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
