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投稿时间：2022-03-27 网络发布日期：2022-12-20
投稿时间：2022-03-27 网络发布日期：2022-12-20
中文摘要: 目的 系统评估经跗骨窦入路（STA）与传统外侧L形入路（ELA）治疗Sanders Ⅱ、Ⅲ型跟骨骨折的疗效。方法 计算机检索中国知网、维普、万方、中国生物医学文献数据库、Cochrane、PubMed和Embase等国内外医学数据库中有关STA和ELA治疗跟骨骨折的临床随机对照试验及临床病例对照研究的相关文献，检索年限设置为2010年1月至2021年12月。筛选符合标准的文献提取有效数据，使用RevMan 5.3软件对数据进行Meta分析。结果 本研究共纳入10篇临床随机对照试验文献，共计676名患者（685足），其中STA组患者338例（343足），ELA组患者338例（342足）。Meta分析结果显示，STA组在手术时长( MD=-0.86， 95%CI：-13.89~-3.31，P＜0.01)、术中出血量( MD=-16.21， 95%CI：-25.58~-6.84，P＜0.01)、术后并发症( MD=0.22， 95%CI：0.13~0.37)，P＜0.01)、住院时间( MD=-5.78， 95%CI：-10.63~-0.93，P＜0.05)、骨折愈合时间( MD=-1.37， 95%CI：-2.19~-0.54，P＜0.01)、Maryland评分优良率( MD=1.20， 95%CI：1.08~1.34，P＜0.01)方面优于ELA组，差异有统计学意义；在术后Bhler角( MD=0.19， 95%CI：-0.44~0.82，P＞0.05)及Gissane角( MD=0.93， 95%CI：-0.20~2.07，P＞0.05)差异无统计学意义。结论 相较于ELA，STA治疗SandersⅡ、Ⅲ型跟骨骨折具有手术时间短、术中出血量及术后并发症少，骨折愈合时间及住院时间缩短等优势，且术后足部放射学方面评价与ELA无差异。
Abstract:Objective To systematically evaluate the efficacy of sinus tarsi approach(STA) and conventional lateral extensile L-shape approach(ELA) in the treatment of Sanders type Ⅱ and Ⅲ calcaneal fractures. Methods The relevant literatures of randomized controlled trials(RCT) and clinical case-control trials(CCT) on the treatment of calcaneal fractures with STA and ELA were retrieved from domestic and foreign medical databases such as CNKI, VIP, WanFang, China Biomedical Literature Database（CBM）, Cochrane, PubMed, Embase, etc. through computer. The retrieval time was set from January 2010 to December 2021. After screening the eligible literatures according to the inclusive criteria for valid data extraction, meta-analysis was perform using RevMan 5.3 software. Results Totally 10 RCT involving 676 patients were included, and there were 338 patients(343 feet) in STA group and 338 patients(342 feet) in ELA group. Meta-analysis results showed that STA group was superior to ELA group in terms of in operation time ［ MD=-0.86, 95%CI (-13.31,-3.31), P＜0.01］, intraoperative bleeding ［ MD=-16.21, 95%CI (-25.58,-6.84), P＜0.01］, postoperative complications ［ MD=0.22, 95%CI (0.13,0.37), P＜0.01］, length of hospital stay ［ MD=-5.78, 95%CI (-10.63,-0.93), P＜0.05］, fracture healing time ［ MD=-1.37, 95%CI (-2.19,-0.54), P＜0.01］and excellent and good rate of Maryland score ［ MD=1.20, 95%CI (1.08,1.34),P＜0.01］. There was no significant difference in postoperative Bhler angle ［ MD=0.19, 95%CI (-0.44, 0.82), P＞0.05］and Gissane angle ［ MD=0.93, 95%CI (-0.20,2.07), P＞0.05］between two groups. Conclusion In the treatment of Sanders type Ⅱ and Ⅲ calcaneal fractures, STA has the advantages of shorter operation time, less intraoperative blood loss and postoperative complications and shorter fracture healing time and hospital stay compared with ELA, and there is no statistical difference in postoperative radiological evaluation of the foot.
keywords: Calcaneal fractures Intra-articular fractures Sinus tarsi approach Extensile lateral approach Open reduction internal fixation
文章编号： 中图分类号： 文献标志码：A
基金项目:山西省留学人员科技活动择优资助项目（20200037）
附件
| 作者 | 单位 |
| 杨博1 | 1. 山西医科大学第一临床医学院，山西 太原 030001 |
| 韩树峰2 | 2. 山西医科大学第一医院，山西 太原 030001 |
| 郝耀2 | 2. 山西医科大学第一医院，山西 太原 030001 |
| Author Name | Affiliation |
| YANG Bo*, HAN Shu-feng, HAO Yao | *The First School of Clinical Medicine of Shanxi Medical University, Taiyuan, Shanxi 030001, China |
引用文本：
杨博,韩树峰,郝耀.经跗骨窦切口与传统外侧L形切口治疗SandersⅡ和Ⅲ型跟骨骨折疗效的Meta分析[J].中国临床研究,2022,35(12):1699-1705.
杨博,韩树峰,郝耀.经跗骨窦切口与传统外侧L形切口治疗SandersⅡ和Ⅲ型跟骨骨折疗效的Meta分析[J].中国临床研究,2022,35(12):1699-1705.