背景:尽管孤立的韦伯B骨折很普遍,手术治疗与保守治疗的相对有效性尚不清楚.本系统评价和荟萃分析旨在探讨手术与保守治疗孤立性WeberB踝关节骨折的临床效果和并发症。
方法:这项研究涉及跨多个电子数据库的彻底搜索,包括PubMed,科克伦,Embase,和WebofScience,确定通过手术与保守治疗修复的孤立性WeberB踝关节骨折的所有相关出版物。通过全面的荟萃分析,评估了几个结果,包括术后功能,并发症和再次手术率。
结果:六篇文章,涉及818名符合纳入标准的患者。在这些参与者中,男性350人,女性636人。651例患者接受保守治疗,396人接受了手术干预。研究结果表明,OMAS没有显着差异,FAOQ,PCS,MCS评分,并恢复手术和非手术治疗孤立的WeberB踝关节骨折的工作。然而,与手术治疗相比,非手术治疗具有较高的AOFAS评分(MD=-5.31,95%CI=[-9.06,-1.55],P=0.20,I2=39%),较低的VAS评分(MD=0.72,95%CI=[0.33,1.10],P=0.69,I2=0%),并发症发生率较低(RR=3.06,95%CI=[1.58,6.01],P=0.05,I2=54%),和较低的再手术率(RR=8.40,95%CI=[1.57,45.06],P=0.05,I2=67%)。
结论:
BACKGROUND: Despite fractures of Isolated Weber B being prevalent, there is a lack of clarity regarding the relative effectiveness of surgical versus conservative treatment. This systematic
review and meta-analysis aimed to investigate the clinical effects and complications of surgical versus conservative treatment of the Isolated Weber B ankle fractures.
METHODS: This study involved thorough searches across multiple electronic databases, including PubMed, Cochrane, Embase, and Web of Science, to identify all relevant publications on Isolated Weber B ankle fractures repaired through surgical versus conservative treatment. Through a comprehensive meta-analysis, several outcomes were evaluated, including post-operative function, complications and reoperation rate.
RESULTS: Six articles involving 818 patients who met the inclusion criteria. Among these participants, 350 were male and 636 were female. 651 patients received conservative treatment, while 396 underwent surgical intervention. The findings indicate no significant differences in OMAS, FAOQ, PCS, MCS scores, and return to work between surgical and non-surgical treatments for isolated Weber B ankle fractures. However, compared with surgical treatment, non-surgical treatment has a higher AOFAS score(MD = -5.31, 95% CI = [-9.06, -1.55], P = 0.20, I2 = 39%), lower VAS score(MD = 0.72, 95% CI = [0.33, 1.10], P = 0.69, I2 = 0%), lower complication rate (RR = 3.06, 95% CI = [1.58, 6.01], P = 0.05, I2 = 54%), and lower reoperation rate(RR = 8.40, 95% CI = [1.57, 45.06], P = 0.05, I2 = 67%).
CONCLUSIONS: