摘要
目的通过Meta分析导致股骨粗隆间骨折髓内固定手术后失败的危险因素。方法检索PubMed、万方、中国知网等数据库,收集自2005-01—2017-12报道股骨粗隆间骨折髓内固定失败危险因素的文献,严格评价纳入研究的质量并提取资料,应用Revman 5.3软件进行系统分析。结果纳入13篇中文文献,均为回顾性非随机对照研究,共2 352例单侧股骨粗隆间骨折,髓内固定方式为股骨近端防旋髓内钉(PFNA)及Gamma钉,其中内固定失败299例。Meta分析显示,高龄、不稳定骨折、外侧壁不稳定、重度骨质疏松、骨折复位欠佳、尖顶距≥25 mm、合并严重基础疾病的患者股骨粗隆间骨折髓内固定失败率更高,差异有统计学意义(P <0.05)。患者性别与股骨粗隆间骨折髓内固定失败无显著相关性(P>0.05)。结论高龄、不稳定骨折、外侧壁不稳定、重度骨质疏松、骨折复位欠佳、尖顶距≥25 mm、合并严重基础疾病是股骨粗隆间骨折髓内固定失败的危险因素。
Objective To evaluate the risk factors related to failure of intramedullary nailing internal fixation for femoral intertrochanterie fractures. Methods The clinical research from January 2005 to December 2017 on risk factors related to the failure of intramedullary nailing internal fixation for femoral intertroehanteric fractures was collected from Pubmed, Wanfang Database, CNKI, et al. Revman 5.3 was used to perform data analysis after quality assessment and retrieval of the qualified data. Results Thirteen Chinese studies were included involving retrospective nonrandomized controlled trails. Two thousand three hundred and fifty-two patients with unilateral intertrochanteric fractures were treated with PFNA or Gamma nail, of whom 299 failed. The failure rate of femoral intramedullary nailing fixation for intertroehanteric fractures was higher in patients of advanced age, unstable fracture, fragile lateral wall, severe osteoporosis, unsatisfactory fracture reduction, TAD I〉 25 mm, concomitant intemal diseases, with statistical significance （P 〈0.05）. There was no statistical significance in gender （P 〉 0.05）. Conclusion Advanced age, unstable fracture pattern, fragile lateral wall, severe osteoporosis, unsatisfactory fracture reduction, overlong TAD, concomitant internal diseases may be the risk factors related to the failure of intramedullary nailing fixation for intertroehanteric fractures.
作者
吴晓天
陈农
何小健
付文芹
WU Xiao-tian;CHEN Nong;HE Xiao-jian;FU Wen-qin(Department of Orthopaedics,Qingpu Branch of Zhongshan Hospital,Fudan University,Shanghai 201700,China)
出处
《中国骨与关节损伤杂志》
2018年第10期1021-1025,共5页
Chinese Journal of Bone and Joint Injury
关键词
股骨粗隆间骨折
髓内钉
内固定失败
META分析
Femoral intertroehanteric fractures
Intramedullary nailing
Internal fixation failure
Meta-analysis
