ABSTRACT
BACKGROUND:Plate fixation or intramedulary fixation for clavicle fractures has remained a matter of debate. At present, there is a need for a higher level of evidence to evaluate the advantages and disadvantages of two different surgical methods. OBJECTIVE:To assess the clinical efficacy of intramedulary fixationversusplate fixation in the treatment of clavicle fractures. METHODS:We conducted a computerized search of the electronic databases like Cochrane Library, PubMed, Embase, OVID, CBM, CNKI, Wanfang and VIP for relevant randomized controled trials on plate fixation or intramedulary fixation for clavicle fractures. The quality of the included studies was independently assessed with RevMan 5.3 software. The meta-analysis was performed in Stata 13.0. RESULTS AND CONCLUSION:Eight randomized controlled trials with 527 patients were included in this meta-analysis. The meta-analysis results showed union time, surgery time, incision length, hospital stay and infection rate were less in the intramedullary fixation group than in the plate fixation group (P< 0.05). No significant difference in shoulder function score, upper limb function score, fracture nonunion and refracture was determined between the two groups (P< 0.05). The current evidences suggested that intramedullary fixation is the optimum choice in the treatment of clavicle fractures.
ABSTRACT
Objective To investigate the clinical significance of preoperative three-dimensional CT scan parameters to restore postoperative limb length and reduce postoperative dislocation in patients with total hip arthroplasty (THA).Methods Clinical data of two groups involving 86 cases that had primary unilateral THA were included.In study group 45 cases were operated on with the measurement of contralateral acetabular anteversion, acetabular abduction angle, distance from femoral neck osteotomy to the center of rotation of the femoral head and distance from femoral trochanter tip to the center of rotation based on three-dimensional CT scan.Another 41 cases under conventional surgery which not used these parameters served as control.Surgical efficacy was compared to verify the role of CT scan parameters in restoring postoperative limb length and reducing postoperative dislocation.Results Period of follow-up was (11.2 ± 6.2) months in study group and (11.6 ± 6.2) months in control group.Harris hip score in study group was (87.2 ± 5.4) points versus (80.9 ± 7.9) points in control group three months after operation (P ＜ 0.05).Limb length discrepancy in study group was (0.4 ± 0.2) cm versus (1.1 ± 0.4) cm in control group (P ＜ 0.05).Each group had one dislocation three months after operation.Conclusion The parameter measurement with three-dimensional CT scan has some guiding significance in THA.