Systematic review of the complications of plate fixation of clavicle fractures.
Systematic review of the complications of plate fixation of clavicle fractures.
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DOI：
10.1007/s00402-011-1456-5
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发表时间：
2012-05
影响因子：
2.3
通讯作者：
Houwert RM
中科院分区：
文献类型：
--
作者：
Wijdicks FJ;Van der Meijden OA;Millett PJ;Verleisdonk EJ;Houwert RM
手术治疗移位的锁骨中段骨折的数量越来越多，钢板固定通常是首选的治疗方式。在文献中，这种治疗可能出现的并发症的研究质量和科学证据水平差异很大。本系统综述的目的是评估脱位锁骨中段骨折钢板固定相关并发症的发生率。使用EMBASE和PUBMED/MEDLINE进行基于计算机的检索。纳入审查的研究报告了单独钢板固定或与髓内针固定治疗和/或非手术治疗相比的并发症。使用两种质量评估工具评估研究的方法学质量。纳入的研究根据其证据等级进行排名。经过研究选择和阅读全文后，11项研究符合最终质量评估的条件。除一项研究外，所有分析研究的骨不连和畸形愈合率均低于10%。绝大多数并发症似乎与植入物相关，几乎每项研究都报告了接骨板的刺激或失效，平均范围为9 - 64%。相关的高证据研究数量较少。由于骨不连和畸形愈合率较低，钢板固定可以作为急性脱位锁骨中段骨折的安全治疗选择，但与植入物材料相关的并发症需要二次手术是常见的。需要进一步的前瞻性试验来分析不同钢板类型和钢板位置对植入物相关并发症的影响。
The number of displaced midshaft clavicle fractures treated surgically is increasing and plate fixation is often the treatment modality of choice. The study quality and scientific levels of evidence at which possible complications of this treatment are presented vary greatly in literature. The purpose of this systematic review is to assess the prevalence of complications concerning plate fixation of dislocated midshaft clavicle fractures. A computer-based search was carried out using EMBASE and PUBMED/MEDLINE. Studies included for review reported complications after plate fixation alone or in comparison to either treatment with intramedullary pin fixation and/or nonoperative treatment. Two quality assessment tools were used to assess the methodological quality of the studies. Included studies were ranked according to their levels of evidence. After study selection and reading of the full texts, 11 studies were eligible for final quality assessment. Nonunion and malunion rates were less than 10% in all analysed studies but one. The vast majority of complications seem to be implant related, with irritation or failure of the plate being consistently reported on in almost every study, on average ranging from 9 to 64%. The quantity of relevant high evidence studies is low. With low nonunion and malunion rates, plate fixation can be a safe treatment option for acute dislocated midshaft clavicle fractures, but complications related to the implant material requiring a second operation are frequent. Future prospective trials are needed to analyse the influence of various plate types and plate position on implant-related complications.
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影响因子：
3
作者：
Kabak, S;Halici, M;Karaoglu, S
通讯作者：
Karaoglu, S
DOI：
10.1016/j.injury.2005.03.007
发表时间：
2005-10-01
影响因子：
2.5
作者：
Coupe, BD;Wimhurst, JA;Patel, AD
通讯作者：
Patel, AD
影响因子：
2.5
作者：
Cho, Chul-Hyun;Song, Kwang-Soon;Lee, Kyung-Jae
通讯作者：
Lee, Kyung-Jae
DOI：
10.1016/0020-1383(94)90183-x
发表时间：
1994-01-01
影响因子：
2.5
作者：
MULLAJI, AB;JUPITER, JB
通讯作者：
JUPITER, JB
影响因子：
3.3
作者：
Rabe, Sarah B.;Oliver, Gretchen D.
通讯作者：
Oliver, Gretchen D.