摘要
[目的]比较手术与非手术治疗移位型跟骨关节内骨折的临床疗效。[方法]计算机检索Conchrane Library、Pub Med、Embase、OVID、CBM、CNKI、万方和维普数据库中关于手术与非手术治疗移位型跟骨关节内骨折的随机对照试验(RCT),检索时限为建库至2015年5月,同时查阅所获取的参考文献索引。两名研究者对检索收集到的文献按照制定的纳入排除标准进行独立筛选。采用美国骨科足与踝关节协会的踝与后足评分系统(AOFAS)、SF-36(PCS)、SF-36(MCS)、术后疼痛、并发症(浅部感染、深部感染)、距下关节融合、不能返回原工作、Bohler角作为评价指标。对纳入文献进行方法学质量评价,采用Review Manager 5.3软件进行Meta分析。[结果]最终纳入7篇随机对照研究RCT,共789例患者。Meta分析结果显示:两组患者在术后美国骨科足与踝关节协会的踝与后足评分系统(AOFAS)、SF-36(MCS)、术后疼痛和距下关节融合方面差异无统计学意义,在SF-36(PCS)、并发症(浅部感染、深部感染)、Bohler角及不能返回原工作方面差异均有统计学意义。[结论]研究结果发现对于患者的远期功能和疼痛情况,手术与非手术治疗效果相似,手术治疗不能减小因距下关节炎而需进行关节融合手术的风险,不过手术能更好的恢复Bohler角及使患者返回原工作,但是手术治疗会有更高的感染风险,易导致并发症。
[Objective]To compared the clinical efficacy of operation versus nonoperation treatment for displaced intra- articular calcaneal fractures（ DIACF）. [Method]We searched the following electronic databases： Cochrane library,Embase,Pub Med,OVID,Chinese Biological Medicine,VIP,Wanfang and China National Knowledge Infrastructure database. The time limit was from the estalishing of these database to May 2015. Methodology was applied for qulity evaluation and meanwhile,the Review Manager 5. 3 software was used for Meta- analysis. [Result]Seven RCTs were included in RCT with 789 patients in all. No statistically significant difference was found in terms of the American Orthopaedic Foot and Ankle Society score（ AOFAS）,SF- 36（ MCS）,postoperative pain and subtalar fusion. Statistic differences were found in SF- 36（ PCS）,complications（ superficial infection and deep infection）,Bhler＇s angle and fail of former work returning.[Conclusion]Results showed that pain and function recovery were similar between operation and nonperation groups. Operation treatment can＇t decrease the incidence of subtalar fusion. However,the patients with operation can resume pre- injury work more easily. Moreover,operation can recovery Bhler＇s angle. At the same time,operation is associated with a high risk of infections and complications.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2016年第2期133-140,共8页
Orthopedic Journal of China
基金
教育部高校博士点基金资助项目(编号:20125503120017)
