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骨平原骨折的手术固定方法

Toby O Smith¹, Laura Casey², Iain R McNamara³

¹Warwick Clinical Trials Unit, University of Warwick, Warwick, UK.

The Cochrane database of systematic reviews

|August 22, 2024

概括

目前的证据不足以确定最佳的手术固定或骨缺陷填充剂用于骨平原骨折. 需要更多高质量的随机对照试验 (RCT) 来指导这些复杂的膝关节损伤的治疗决策.

科学领域:

整形外科手术整形外科手术
创伤管理创伤管理
生物材料科学生物材料科学

背景情况:

骨平原骨折是关节内膝关节损伤,并发症率高,包括早期关节炎.
复杂骨折的手术固定是常见的,通常涉及骨缺陷填充剂.
目前的治疗缺乏关于最佳固定方法和骨缺陷填充剂的必要性的一致意见.

研究的目的:

评估各种手术干预的好处和危害,用于骨平原骨折.
评估用于治疗这些骨折的不同骨缺陷填充剂的疗效.

主要方法:

在CENTRAL,MEDLINE,Embase和试验注册表中进行系统搜索,直到2023年3月.
包括随机对照试验 (RCT) 和准RCT,比较手术技术和骨填充剂.
独立的数据提取和偏差风险评估,与GRADE确定性评估.

主要成果:

纳入了15项试验 (948名参与者),所有试验都具有偏见的高风险和证据确定性非常低.
有限的证据表明,与ORIF相比,混合固定可能对功能或重新运行几乎没有影响,但非常不确定.
单板ORIF和双板ORIF在功能方面没有发现显著差异,证据非常不确定.

结论:

目前还没有足够的证据来推特殊的手术固定方法,用于骨平原骨折.
在这些骨折中管理骨缺陷的最佳方法仍然不清楚.
需要进一步的精心设计的RCT,采用更大的样本大小,以建立最佳实践.

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