对小儿科上下骨骨折的钉钉技术的比较分析:随机对照试验的系统审查和元分析
S Umar Hasan1, Alina Pervez1, Shajie Ur Rehman Usmani2
1Aga Khan University, Karachi, Pakistan.
Journal of orthopaedics
|August 28, 2023
概括
在儿科上下骨折 (SCHFs) 中,侧边钉是更安全的,与交叉钉相比,可以显著降低阴神经损伤的风险. 这些常见的儿科骨折固定方法之间的其他结果是相似的.
科学领域:
- 儿科整形外科 儿科整形外科
- 手术技巧 手术技巧
- 基于证据的医学基于证据的医学.
背景情况:
- 骨骨折 (SCHF) 在儿童中很常见.
- 对于儿科SCHF的最佳手术固定方法缺乏共识.
- 钉技术经常用于SCHF处理.
研究的目的:
- 为了比较儿童SCHFs的交叉钉与横向钉的安全性和有效性.
- 评估结果,包括阳性部神经损伤,功能结果和感染率.
- 提供基于证据的推,用于选择手术技术在儿科supracondylar骨骨折管理.
主要方法:
- 22个随机对照试验 (RCT) 的系统审查和元分析.
- 提取巴曼角,承载角,肘部功能 (弗林标准),管感染和部神经损伤的数据.
- 随机效应建模用于结果的统计分析.
主要成果:
- 通过交叉钉 (OR 3.76) 观察到具有明显较高的阴性部神经损伤风险.
- 对于其他评估结果,交叉钉和横钉之间没有发现显著差异.
- 来自20个RCT的数据为部神经损伤分析做出了贡献.
结论:
- 建议在交叉钉上进行侧侧钉,以最大限度地降低儿科SCHFs中阳性部神经损伤的风险.
- 外科医生应该考虑横向固定,以提高患者的安全性.
- 这两种技术在其他手术内和术后结果方面都显示出可比的结果.
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