摘要
目的:系统评价跗骨窦切口和传统"L"形切口治疗成人跟骨骨折的疗效。方法:计算机检索Pubmed、中国生物医学文献数据库、CNKI、万方数据库、维普资讯数据库等中英文数据库,检索截止日期为2018年5月,收集跗骨窦切口和传统"L"形切口治疗跟骨骨折的随机对照研究和队列研究,提取有效数据,应用RevMan 5.3软件对数据进行统计分析。结果:共纳入15篇文献,1 080足,其中跗骨窦切口537足,传统"L"形切口543足。Meta分析结果显示,与"L"形切口治疗组相比,跗骨窦切口治疗跟骨骨折术后切口并发症发生率明显降低(OR=0.28,95%CI:0.16～0.47,P<0.000 01),手术时间明显缩短(MD=-24.96,95%CI:-32.86～-17.07,P<0.000 01),术中出血量明显减少(MD=-60.71,95%CI:-82.86～-38.56,P<0.000 01),术后VAS评分明显降低(MD=-1.42,95%CI:-2.15～-0.69,P=0.000 1)。两种手术切口在跟骨B9hler角、Gissane角、AOFAS评分、Maryland评分及术后疗效方面无统计学差异。结论:现有研究结果显示跗骨窦切口术后并发症发生率较低,与传统"L"形切口复位效果大致相同,是一种治疗跟骨骨折的有效方法。
Objective:To systematically review the existing evidence about the effect of open reduction via sinus tarsi incision and traditional L-shaped incision for calcaneal fracture in adults.Methods:The databases including Pubmed,CNKI,Wanfang,and VIP were searched for the relevant randomized controlled trials and clinical control trails up to May,2018.Results:A total of 15 trails were included,with 1 080 cases of calcaneal fractures in all.There were 537 cases in sinus tarsi incision group and 543 cases in the traditional L-shaped incision group.Compared with the traditional L-shaped incision group,there were lower wound complication(OR=0.28,95%CI:0.16 to 0.47,P<0.000 01),shorter operation duration(MD=-24.96,95%CI:-32.86to-17.07,P<0.000 01),fewer volume of introoperative hemorrhage(MD=-60.71,95%CI:-82.86to-38.56,P<0.000 01)and lower VAS score(MD=-1.42,95%CI:-2.15to-0.69,P=0.000 1)in the sinus tarsi incision group.However,there was no significant difference of B9 hler angle,Gissane angle,AOFAS score,Maryland score and postoperativecurative effect between the two groups.Conclusion:Open reduction via sinus tarsi incision has lower incidence of complication,and roughly the same replacement effect with traditional L-shaped incision,which is an effective strategy for calcaneal fracture.
作者
陈明亮
谷成毅
丁松
周游
Chen Mingliang;Gu Chengyi;Ding Song;Zhou You(Department of Orthopedics,Affiliated Renhe Hospital of China Three Gorges University,Yichang 443001,China)
出处
《巴楚医学》
2018年第4期60-67,共8页
Bachu Medical Journal
基金
湖北省自然科学基金面上项目(No:ZRMS2016001220)
三峡大学科研启动基金(No:KJ2015A027)
