Pauwels三型股骨颈骨折不同内固定方式的 meta分析
A meta-analysis of different internal fixation strategies of Pauwels Ⅲ femoral neck fractures

目的 ·系统评价空心钉（ cannulated screw，CS）与滑动髋螺钉（ sliding hip screw，SHS）固定 Pauwels三型股骨颈骨折的疗效和功能恢复情况。方法 ·计算机检索三大英文数据库 PubMed、Embase、Cochrane，及中文数据库 CNKI、Sinomed，使用 Revman 5.26软件对纳入文献进行 meta分析。结果 ·最终选出 6篇临床研究，共包含病例 350例，其中 CS固定组 213例，SHS固定组 137例。通过分析得出， SHS固定术后骨不连率显著低于 CS固定，但是 CS固定手术时间更短。结论 ·对于 Pauwels三型股骨颈骨折， SHS可以显著减少术后骨不连的发生，但是手术过程相对复杂，并存在术中出血量大、术后功能评分低的趋势。
：Objective · To compare the clinical and functional outcomes of cannulated screw (CS) with sliding hip screw (SHS) in the fixation of Pauwels Ⅲ femoral neck fractures systematically. Methods · In the meta-analysis, articles were searched Pubmed database, Embase database, Cochrane library, CNKI database, and Sinomed database. The selected articles were analyzedRevman 5.26 software. Results · Six clinical studies met the inclusion criteria. A total of 350 patients including 213 with CS fixations and 137 with SHS fixations were pooled in the meta-analysis. The results showed that the non-rate in SHS group was significantly lower than that in CS group. However, the surgery time was significantly shorter in CS group. Conclusion · SHS fixation has the advantage of reducing postoperative non-rate in Pauwels Ⅲ femoral neck fractures, but the operative process is relatively complicated, which seemingly causes more blood loss during surgery, and may lead to a less satisfactory functional recovery