Meta-analysis Of Double Endobutton Plate And CHP In The Treatment Of Tossy ? Acromioclavicular Joint Dislocation

Objective:To explore the domestic literature on the use of double Endobutton plate and clavicular hook plate for the treatment of Tossy type III acromioclavicular joint dislocation,to evaluate the clinical effect and safety of the two.Methods:Retrieval of Chinese databases,including cnki,CBM,wanfang,wipo,etc.;The time interval for publication of the literature retrieval was set as from December2008 to December 2018.The literature retrieval was the research literature for comparing the effect of double Endobutton and CHP in the treatment of Tossy III acromioclavicular dislocation,and the language of the paper was Chinese.The risk of bias and the extracted data were assessed by two reviewers according to the Cochrane manual criteria.Results:A total of 895 patients were included in 15 clinical studies,including 425 patients in the double Endobutton plate group(observation group,E group)and 470 patients in the clavicular hook plate group(CHP,control group,C group).Meta analysis was performed on 11 observation indexes of the two surgical methods,and the results showed that there was no significant difference in hospitalization time(p=0.71,p value>0.05).The last follow-up postoperative shoulder joint Karlsson crop(p=0.04),the former(p<0.00001)lift on flexion mobility,lift on outreach activity(p< 0.00001),the Constant-Murley score(p<0.00001),VAS(visual analog pain score)(p<0.00001),postoperative recovery time(p<0.00001),the operation time(p< 0.00001),intraoperative blood loss(p= 0.003),p value is less than 0.05,statistically significant.The incidence of complications in the CHP group was higher than that in the Endobutton plate group: shoulder joint pain in the last postoperative follow-up(p=0.0003)and limited shoulder joint movement in the last postoperative follow-up(p<0.0001),p values were less than 0.05,with statistical significance.Conclusion:In terms of postoperative efficacy,it is difficult to evaluate the difference between the two surgical methods in terms of hospitalization time.In terms of excellent and good rate,forward flexion and abduction activity,Constant score,VAS score and recovery time,the double Endobutton plate group is better.Postoperative safety: complications(shoulder joint pain and limitation)were better in the double Endobutton plate group than in the clavicular hook plate group.In terms of intraoperative safety,the double Endobutton plate group was slightly inferior to the clavicular hook plate group in terms of operation time and intraoperative blood loss.Therefore,double Endobutton plate fixation is a more recommended surgical method.