比较钢板和髓内钉治疗成人肱骨骨折骨不连疗效的meta分析OA

Objective To compare the effects between steel plate and intramedullary nail in treating a-dult humeral fracture nonunion.Methods The literatures on the treatment of adult humeral fractures nonun-ion by using steel plates and intramedullary nails were retrieved from CNKI,Wanfang,VIP,Chinese Biomedic-al Literature Database,Pubmed Database,Embase Database,and Cochrane Library.The time limit was from the establishment of each database to February 7,2023.After literature screening,quality evaluation and data extraction,the meta analysis was conducted by using RevMan 5.4.1 software.Results A total of 10 clinical controlled studies were included,with a total of 668 patients.Among them,336 patients were treated with steel plates and 332 patients were treated with intramedullary nails.The meta analysis results showed that the use of intramedullary nail in the treatment of humeral fracture nonunion was superior to the use of steel plate in the treatment of humeral fracture nonunion in terms of intraoperative bleeding(MD=5.51,95％CI 3.17-7.85,P＜0.000 01),fracture healing time(MD=32.22,95％CI 11.32-53.12,P=0.003),postoperative complications(MD=2.96,95％CI 1.71-5.12,P=0.000 1)and postoperative infection(OR=4.10,95％CI 1.84-9.13,P=0.000 5),and the differences were statistically significant.However,there was no statistical difference in terms of operation time,postoperative radial nerve injury,postoperative joint movement limita-tion and postoperative re-fracture between the two groups.Conclusion In clinical practice,the intramedul-lary nail fixation has certain advantages over steel plate in treating adult humeral fracture nonunion,but more clinical trial data are still needed to provide more sufficient evidences.