天津医药

• 循证医学 •    

经皮加压钢板与动力髋螺钉治疗老年股骨粗隆间骨折的 Meta分析

贾军1,冯世庆2,李卫哲3,吴英华3   

  1. 1. 天津市天津医院创伤骨科科
    2. 天津市天津医科大学总医院
    3. 天津市天津医院
  • 收稿日期:2012-07-02 修回日期:2012-11-29 出版日期:2013-07-15 发布日期:2013-07-15
  • 通讯作者: 冯世庆

A Meta-Analysis of Percutaneous Compression Plate versus Dynamic Hip Screw in the Treatment of Intertrochanteric Hip Fractures in Elderly Patients

JIAJun 1,FENG Shiqing 2,LI Weizhe 1,WU Yinghua 1   

  1. 1. Department of Orthopedics and Trauma, Tianjin Hospita
    2. Department of Orthopedic Surgery, General Hospital of Tianjin Medical University, Tianjin 300052, China
  • Received:2012-07-02 Revised:2012-11-29 Published:2013-07-15 Online:2013-07-15
  • Contact: FENG Shiqing

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摘要：

【摘要】 目的 比较采用经皮加压钢板（PCCP）与动力髋螺钉（DHS）治疗老年股骨粗隆间骨折的疗效。 方法  计算机检索 Cochrane 图书馆、Medline 、Embase、中文期刊全文数据库、万方数据库等资源， 检索 PCCP与 DHS 治疗老年股骨粗隆间骨折的随机临床对照试验或非随机临床对照试验， 在提取数据和评价纳入研究的方法学质量后， 通过Meta分析比较两种方法治疗老年人股骨粗隆间骨折的疗效。 结果 共检索到 231 篇原始文献， 最终纳入 11 篇， 共1 100 例患者； 分析结果表明 PCCP 相对于 DHS 手术时间短 [WMD=-12.83， Z=2.54， P = 0.01]、 手术切口长度小[WMD =-7.43， Z=3.35， P< 0.001]、术中出血量低[WMD = -211.41， Z=9.07， P< 0.001]， 而且预后较好， 但术后住院时间差异无统计学意义（WMD=-1.28,Z=0.89， P=0.37）。 结论 PCCP更适用于老年患者股骨粗隆间骨折的治疗。

关键词: 骨螺丝, 骨折固定术, 内, 股骨骨折, 老年人, Meta分析, 经皮加压钢板, 动力髋螺钉

Abstract: Abstract    Objective   To compare the efficacy of percutaneous compression plate (PCCP) and dynamic hip screw (DHS) for intertrochanteric fractures of the aged. Methods   We searched the Cochrane Library, PubMed, EMbase, CNKI, Wanfang database and other databases. Retrieved the case-control study which used percutaneous compression plate and dynamic hip screw to treat intertrochanteric fractures of the aged, then compared the efficacy of percutaneous compression plate and dynamic hip screw for this kind of fractures by meta-analysis. Results   In 231 citations initially identified, 12 eligible papers, which included a total of 1159 patients followed up, met all the final criteria. We compared the operation duration, blood loss, wound healing, complications, fracture healing and functional outcome et al between PCCP and DHS. The results showed that the PCCP had a better outcome in the operation duration, blood loss, wound healing compared to the DHS, but it didn't show significant difference in the postoperative infection rate and mortality. Conclusions    The current analysis shows that the PCCP ( a quicker operation with minimal blood loss) is better in the older patients, but there should be more larger sample randomized controlled trials to provide decision-making evidence for clinical treatment of intertrochanteric fractures.

Key words: bone screw, fracture fixation, internal, femoral fracture, aged, Meta analysis, percutaneous compression, 动力髋螺钉