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首页> 美国卫生研究院文献>International Journal of Clinical and Experimental Medicine >Treatment of complex proximal humeral fracture: plate and tension band fixation versus conservative therapy
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Treatment of complex proximal humeral fracture: plate and tension band fixation versus conservative therapy

机译：复杂性肱骨近端骨折的治疗：钢板和张力带固定与保守治疗

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Background: There is no consensus on the optimal treatment for patients with complex proximal humeral fractures. A meta-analysis was performed to evaluate clinical effectiveness of plate and tension band fixation compared with conservative therapy. Methods: We systematically searched electronic databases (Pubmed, Medline, Embase, Cochrane library and Google Scholar) to identify comparative studies and randomized controlled trials in which plate and tension band fixation was compared with conservative treatment of the complex proximal humeral fractures from 1995 to 2013. The quality of the studies was assessed and effective data were pooled for meta-analysis. Results: A total of 222 patients from three RCTs and three comparative studies were included in this meta-analysis (113 fractures treated with plate and tension band and 109 with conservative treatment). The primary and secondary outcomes (Constant Score, nonunion, avascular necrosis and osteoarthritis) were compared and there was no significant difference among these different treatments of this injury. Conclusions: Compared with conservative treatment, internal fixation including plate and tension band did not find better shoulder function, higher rate avascular necrosis of humeral head, lower rate nonunion, and higher rate osteoarthritis. In further, high quality and large randomized trials should be recommended to make a choice between these treatment modalities.
机译：背景：对于复杂的肱骨近端骨折患者的最佳治疗方法尚无共识。进行荟萃分析，以评估钢板和张力带固定与保守治疗相比的临床有效性。方法：我们系统地搜索了电子数据库（Pubmed，Medline，Embase，Cochrane库和Google Scholar），以进行比较研究和随机对照试验，比较了1995年至2013年钢板和张力带固定与保守治疗肱骨近端复杂骨折的疗效评估研究的质量，并收集有效数据进行荟萃分析。结果：这项荟萃分析共纳入来自三项RCT和三项比较研究的222例患者（113例接受钢板和张力带治疗的骨折，109例接受保守治疗）。比较了主要和次要结局（常数评分，骨不连，无血管坏死和骨关节炎），并且在这些不同的损伤治疗方法之间没有显着差异。结论：与保守治疗相比，包括钢板和张力带在内的内固定没有发现更好的肩部功能，较高的肱骨头缺血性坏死率，较低的骨不连率和较高的骨关节炎率。此外，应建议高质量和大型随机试验在这些治疗方式之间做出选择。

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