【摘要】 目的对动力髋与Gamma钉两种内固定物治疗成人股骨粗隆间骨折的疗效进行Meta评价。方法计算机检索MEDLINE、EMBASE、Cochrane图书馆、Cochrane协作网肌骨创伤组试验数据库和中国生物医学文献数据库,收集所有相关随机对照试验及半随机对照试验,且采用RevMan 4.2.10进行Meta分析。结果共纳入8个随机对照试验,1个半随机对照试验。Meta分析显示,Gamma钉组术中和术后股骨干骨折的发生率明显增加,二次手术率较高。结论与动力髋组治疗股骨粗隆间骨折相比,Gamma钉组术中和术后股骨干骨折的发生率明显增加,二次手术率更高。但两种内固定器械与拉力螺钉切割出股骨头、术区深部感染、血栓栓塞发生率等的关系尚需更多设计严格的大样本随机对照试验进一步研究。更多还原

【Abstract】 Objective To evaluate the effectiveness of Gamma nails versus dynamic hip screws and plates for treatment of intertrochanteric fractures of the femur in adults.Methods Randomized controlled trials(RCTs) and clinical controlled trials(CCTs) were identified from MEDLINE,EMBASE,Cochrane Library,Cochrane Musculoskeletal Injuries Group Database and CBM disc.Chinese Journal of Orthopaedy and Orthopaedic Journal of China were searched by hand.RCTs and CCTs were included.Data were extracted by two reviewers with designed extraction form.RevMan 4.2.10 software was used for data analysis.Results Eight RCTs and one CCTS were included.The combined results of meta-analysis showed that compared with dynamic hip screws and plates,Gamma Nails could increase the rate of operative and post-operative fractures of the femoral diaphysis and the rate of reoperation.Conclusion Compared with dynamic hip screws and plates,Gamma nails can increase the rate of operative and post-operative fractures of the femoral diaphysis and the rate of reoperation.However,the relation between two operations and cut-out of the lag screws from the femoral head,deep wound infection,thromboembolic complications needs more randomized controlled trials to draw more definite conclusions.更多还原