目的:本荟萃分析的目的是比较碳纤维增强聚醚醚酮(CFR-PEEK)和钛板治疗肱骨近端骨折(PHFs)的疗效和安全性。
方法:对英文数据库进行了全面检索,比如PubMed,WebofScience,ScienceDirect,Springer和Cochrane图书馆数据库。采用RevMan5.1版软件进行统计分析,以平均差(MD)和风险差(RD)作为组合变量,和“95%”作为置信区间(CI)。
结果:一项随机对照试验和5项包括282个PHF的回顾性对照研究被认为是合格的,并最终被纳入。Meta分析显示Constant评分(CS)存在显著差异(MD=9.23;95%CI:5.02,13.44;p<0.0001),前抬高(MD=18.83;95%CI:6.27,31.38;p=0.003),侧向抬高(MD=18.42;95%CI:3.64,33.19;p=0.01)和内收(MD=3.53;95%CI:0.22,6.84;p=0.04)。与对侧肩相比,Constant评分无显著差异,牛津肩分数,内部旋转,外部旋转,螺钉穿孔和切口,内翻/外翻畸形,肱骨头塌陷/坏死,移除植入物,两组进行翻修手术。
结论:与钛板相比,CFR-PEEK板显示更好的Constant评分,前抬高,治疗PHFs的侧向抬高和内收。并发症与使用常规钛板获得的并发症相当。
OBJECTIVE: The aim of the present meta-analysis was to compare the efficacy and safety of the carbon fiber-reinforced polyetheretherketone (CFR-PEEK) and titanium plate for the treatment of proximal humeral fractures (PHFs) from clinical comparative trials.
METHODS: A comprehensive search of English databases was carried out, such as PubMed, Web of Science, ScienceDirect, Springer and Cochrane Library databases. The RevMan version 5.1 software was applied for statistical analysis, and the mean difference (MD) and risk difference (RD) as the combined variables, and \"95%\" as the confidence interval (CIs).
RESULTS: One randomized-controlled trial and five retrospective controlled studies including 282 PHFs were considered eligible and finally included. Meta-analysis demonstrated that there were significant differences in Constant score (CS) (MD=9.23; 95% CI: 5.02, 13.44; p<0.0001), anterior elevation (MD=18.83; 95% CI: 6.27, 31.38; p=0.003), lateral elevation (MD=18.42; 95% CI: 3.64, 33.19; p=0.01) and adduction (MD=3.53; 95% CI: 0.22, 6.84; p=0.04). No significant differences were observed regarding Constant score compared to the contralateral shoulder, Oxford Shoulder Score, internal rotation, external rotation, screw perforation and cutout, varus/valgus malalignment, humeral head collapse/necrosis, implant removal, and revision surgery between the two groups.
CONCLUSIONS: Compared to titanium plate, CFR-PEEK plate showed better Constant score, anterior elevation, lateral elevation and adduction in treating PHFs. The complications are comparable to those achieved with conventional titanium plates.