■锁骨骨折是成人最常见的上肢骨折,中轴区域是受影响最频繁的部位。微创钢板接骨术(MIPO)已成为传统切开复位内固定(ORIF)技术的替代方法,提供潜在优势。这项研究的目的是进行系统的回顾,以探索该技术在现有文献中的结果,强调手术并发症的发生和功能结局,并提供MIPO和ORIF在锁骨中段骨折治疗中的综合比较。
■我们进行了系统评价,以评估MIPO治疗锁骨中段骨折的并发症发生率和临床结果。我们搜索了PubMed/医学文献分析和在线检索系统(MEDLINE),Scopus,Cochrane受控试验数据库,和Cochrane系统评论数据库数据库,没有语言或日期限制。包括了针对MIPO治疗锁骨中段骨折的研究,而其他锁骨骨折和非临床研究被排除。使用非随机研究的方法学指数标准和偏倚风险工具2Cochrane工具评估偏倚风险。数据综合包括定性分析,如果适用,定量分析和荟萃分析。坚持系统审查和荟萃分析指南的首选报告项目可确保报告质量。
■最初总共确定了107项研究,在应用纳入和排除标准后,22项研究纳入数据提取。这些研究涉及评估用MIPO技术治疗的714个锁骨。在714起MIPO案件中,11例植入物失败,5个不结合,2感染,观察到28例神经功能缺损。将MIPO与ORIF进行比较的定量分析显示,MIPO的手术时间明显缩短(平均差-12.95,95%置信区间[-25.27to-0.63],P=.04)和较低的麻木发生率(比值比0.29,95%CI[0.15-0.56],P=.0002)与ORIF相比。骨头愈合的时间,功能结果,在最后一次随访时,MIPO和ORIF的其他并发症相似.在研究中发现总体上中等偏倚风险。
■对于锁骨中段骨折,MIPO技术产生了与ORIF相当的良好结果。此外,MIPO技术可能具有缩短手术时间和降低神经功能缺损几率等优势.
UNASSIGNED: Clavicle fractures are among the most common upper limb fractures in adults, with the midshaft region being the most frequently affected site. Minimally invasive plate osteosynthesis (
MIPO) has emerged as an alternative to the traditional open reduction and internal fixation (ORIF) technique, offering potential advantages. The purpose of this study was to conduct a systematic review to explore the results of this technique in the existing literature, with emphasis on the occurrence of surgical complications and functional outcomes and also to provide a comprehensive comparison of
MIPO and ORIF in the management of midshaft clavicle fractures.
UNASSIGNED: We conducted a systematic review to evaluate the complication incidence and clinical outcomes of MIPO for midshaft clavicle fractures. We searched PubMed/Medical Literature Analysis and Retrieval System Online (MEDLINE), Scopus, the Cochrane Database of Controlled Trials, and the Cochrane Database of Systematic Reviews databases without language or date restrictions. Studies focusing on midshaft clavicle fractures treated with
MIPO were included, while other clavicle fractures and nonclinical studies were excluded. The risk of bias was assessed using the Methodological Index for Nonrandomized Studies criteria and the Risk of Bias Tool 2 Cochrane tool. Data synthesis included qualitative analysis, and if applicable, quantitative analysis and meta-analysis. Adherence to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines ensured reporting quality.
UNASSIGNED: A total of 107 studies were initially identified, after applying inclusion and exclusion criteria, 22 studies were included for data extraction. These studies involved the evaluation of 714 clavicles treated with the
MIPO technique. Of the 714 MIPO cases, 11 cases of implant failure, 5 nonunions, 2 infections, and 28 cases with neurological impairment were observed. Quantitative analysis comparing
MIPO with ORIF revealed that
MIPO had significantly shorter surgery time (mean difference -12.95, 95% confidence interval [-25.27 to -0.63], P = .04) and lower occurrence of numbness (odds ratio 0.29, 95% CI [0.15-0.56], P = .0002) compared to ORIF. Time to bone union, functional outcomes, and other complications were similar between MIPO and ORIF at the final follow-up. An overall moderate risk of bias was found across the studies.
UNASSIGNED: The MIPO technique yields good and comparable results to ORIF for midshaft clavicle fractures. Additionally, the MIPO technique may offer advantages such as reduced surgical time and lower chances of neurological impairment.