背景:本荟萃分析的目的是比较双焦点骨转运(BFT)和三焦点骨转运(TFT)治疗骨折相关感染(FRI)引起的胫骨骨缺损的疗效和结果。
方法:科克伦图书馆的文献检索,Embase,谷歌学者数据库,PubMed/Medline,和WebofScience进行了截至2022年9月20日发表的文献。根据MINORS量表评价纳入研究的质量。将患者分为BFT组和TFT组,根据截骨部位的不同.人口统计数据,缺陷大小(DS),外固定时间(EFT),外固定指数(EFI),骨骼和功能结果,并发症,使用ReviewManager软件(5.3版)提取和分析自体骨移植(ABG)。
结果:本荟萃分析调查的5项研究包括484例胫骨骨缺损患者,平均骨缺损9.3厘米。DS差异有统计学意义(MD=-2.38,95%CI-3.45~-1.32,P<0.0001),EFT(MD=103.44,95%CI60.11至146.77,P<0.00001),BFT组和TFT组之间的EFI(MD=26.02,95%CI14.38至37.65,P<0.00001)。骨结果无统计学差异(RR=0.98,95%CI0.91~1.06,P=0.67),功能结果(RR=0.94,95%CI0.82至1.07,P=0.37),并发症(OR=1.57,95%CI0.59~4.14,P=0.36),两组之间的ABG(RR=1.2,95%CI0.78至1.84,P=0.42)。
结论:TFT是治疗FRI引起的大量胫骨骨缺损的可行和实用的方法,可获得较短的EFT和令人满意的骨和功能效果。
BACKGROUND: The purpose of this meta-analysis was to compare the efficacy and outcomes of bifocal bone transport (BFT) and trifocal bone transport (TFT) for the treatment of tibial bone defects caused by fracture-related infection (FRI).
METHODS: The literature searches of Cochrane Library, Embase, Google Scholar databases, PubMed/Medline, and Web of Science for literature published up to September 20, 2022, were performed. The quality of the included studies was evaluated according to the MINORS scale. Patients were divided into the BFT group and the TFT group, depending on the site of the osteotomy. The demographic data, defect size (DS), external fixation time (EFT), external fixation index (EFI), bone and functional results, complications, and autologous bone grafting (ABG) were extracted and analyzed using the Review Manager software (version 5.3).
RESULTS: Five studies included 484 patients with tibial bone defects treated by bone transport investigated in this meta-analysis, with a mean bone defect of 9.3 cm. There were statistical differences in DS (MD = - 2.38, 95% CI - 3.45 to - 1.32, P < 0.0001), EFT (MD = 103.44, 95% CI 60.11 to 146.77, P < 0.00001), and EFI (MD = 26.02, 95% CI 14.38 to 37.65, P < 0.00001) between BFT group and TFT group. There was no statistical difference in bone results (RR = 0.98, 95% CI 0.91 to 1.06, P = 0.67), functional results (RR = 0.94, 95% CI 0.82 to 1.07, P = 0.37), complications (OR = 1.57, 95% CI 0.59 to 4.14, P = 0.36), and ABG (RR = 1.2, 95% CI 0.78 to 1.84, P = 0.42) between two groups.
CONCLUSIONS: TFT was a feasible and practical method in the treatment of massive tibial bone defects caused by FRI to receive shorter EFT and satisfactory bone and functional results.