Meta Analysis Of The Therapeutic Effects Of Clavicular Hook Plate And Kirschner Tension Band For The Treatment Of Distal Clavicle Fractures And Acromioclavicular Joint Dislocation

Background:Surgical treatment of distal clavicle fractures and acromioclavicular joint dislocation has different internal fixation,which Clavicular hook plate and Kirschner tension band of two internal fixation surgery is more common in two ways,most domestic and foreign medical workers only retrospective case analysis of the two surgical procedures,therefore, in order to improve the surgical treatment of distal clavicle fractures and acromioclavicular joint dislocation of the efficacy and the rational use of medical resources,two systematic reviews the pros and cons of surgical approach becomes extremely important,the only way to a more rational use of medical resources and provide an effective basis for rational decision-making clinical work.Objects: To Meta analyze the therapeutic effects of clavicular hook plate and kirschner tension band for the treatment of distal clavicle fractures and acromioclavicular joint dislocation.Methods: The strategy for the Cochrane Library, Pub Med, Medline, EMbase, CNKI, VIP and other retrieval were searched; manual search policy for six kinds of Chinese magazines have a high impact on the field of orthopedics were searched, while attached to the included studies References were conducted inspection. Collect clavicular hook plate and Kirschner tension band for the treatment of distal clavicle fractures and acromioclavicular joint dislocation RCTs. Observations by extracting data in each study surgery, and the use of Stata12.0 software for data analysis and processing.Results: After the screening of the final included 13 documents, a total of 1175 cases included patients, including 598 patients CHP group, TB group of 577 patients, the use of Stata12.0 software for data analysis and processing, Meta analysis showed that, compared to the therapeutic effects of CHP and TB in the treatment of distal clavicle fractures and acromioclavicular joint dislocation: RR = 1.12,95% CI(1.02,1.23), P = 0.023, prompted two surgical efficacy in a statistically significant difference; RR = 0.35,95% CI(0.26,0.46), P = 0.000, prompted two surgical procedures in terms of safety there is significant difference; RR = 1.19,95% CI(1.12,1.26), P = 0.000, prompted two surgical methods excellent rate difference was statistically significant; RR = 0.42,95% CI(0.25,0.70), P = 0.001, prompted two surgical methods in terms of postoperative shoulder pain difference was statistically significant; RR = 0.49,95% CI(0.29,0.82), P = 0.007, prompted two limited shoulder mobility after differences in terms of mode of operation was statistically significant; RR = 0.13,95% CI(0.05,0.33), P = 0.000, the difference in terms of postoperative fixation failure prompted two surgical methods There was statistically significant; RR = 0.18,95% CI(0.09,0.35), P = 0.000, prompted difference in terms of postoperative dislocation of two surgical methods were statistically significant; RR = 0.35,95% CI(0.26, 0.46), P = 0.000, prompted two surgical methods on postoperative complications were statistically significant differences; RR =-0.09,95% CI(- 0.29,0.10), P = 0.347, prompted two surgical methods In the operation time difference was not statistically significant; RR = 0.14,95% CI(-0.08,0.37), P = 0.218, prompted two surgical modalities for bleeding difference was not statistically significant. Conclusion: Compared with the traditional tension band internal fixation, clavicular hook plate internal fixation surgery have no difference in terms of time and the amount of bleeding; clavicular hook plate internal fixation and excellent efficacy rates are superior to fixed Kirschner wire tension band mode; postoperative safety and postoperative shoulder pain, limited shoulder mobility, internal fixation failure, and other complications were less than redislocation tension band internal fixation, therefore, the use of clavicular hook plate treatment of internal fixation of distal clavicle fractures and acromioclavicular joint dislocation efficacy is superior to the traditional tension band fixation treatment, and it has a small incision, simple operation, stable fixation, fewer complications, conducive to the early exercise. Therefore, clavicular hook plate internal fixation surgery is a safe and effective way, it is worth in clinical widely used.