| Objective: to systematically evaluate the clinical efficacy of artificial prosthesis replacement and open reduction and internal fixation for Mason Ⅲ radial head fracture by searching the relevant literature at home and abroad in the past ten years.To compare the curative effect and prognosis of the two surgical methods and to provide reference for the selection of clinical treatment.Methods: According to the search strategy recommended by Cochrane Collaboration Network,we collected the clinical trials related to Mason type Ⅲ radial head fracture,The search time of the database was limited to January 2010 and December 2020,We,by computer,searched Pub Med,Embase,medine and Cochrane Library database,Wanfang database,CNKI,VIP journal and other related databases used subject words and free words to conduct literature search.The key words in Chinese were radial head fracture,prosthesis replacement,open reduction and internal fixation;the key words in English were radial head fracture,prosthetic replacement/radial head replacement,open reduction and internal fixation,Mason type Ⅲ.For all the documents retrieved,we can further expand the scope of our search through the references given in order to increase our data.Results: The author systematically searched the subject words,A total of 458 articles were found,(Of which 301 are in Chinese,157 in English),in the end,seven papers,Statistics included in the literature get into the object of study of351 people,open reduction and internal fixation group of 171 people,radial head replacement for 180 people,Analysis of the results showed that the two treatment options in the postoperative elbow function score [SMD=5.36,95%CI(1.82,8.90),P=0.003],postoperative Complications [OR=0.16,95%CI(0.06,0.42),P=0.0002],postoperative satisfaction [OR=3.63,95%CI(1.50,8.81),P=0.004],and other indicators,Radial prosthesis replacement is superior to open reduction and internal fixation,difference was statistically significant(P<0.05);Postoperative flexion activity of elbow[SMD=0.42,95%CI(-0.39,1.24),P=0.31],dorsal extension activity of elbow [SM D=-0.13,95%CI(-0.79,0.53),P=0.70],pronation activity of forearm [SMD=2.84,95%CI(-1.51,7.20),P=0.20],supination activity of forearm [SMD=1.25,95%CI(-5.89,8.38),P= 0.73],etc.Comparison of prosthetic replacement and open reduction and fi-xation,and the difference was not statistically significant(P>0.05).Conclusion: In this study,through the meta-analysis of the included literature,it is concluded that compared with open reduction and internal fixation,prosthetic replacement has better elbow function score,lower incidence of postoperative complications and higher postoperative satisfaction in the treatment of Mason Ⅲ radial head fracture.At the same time,we need to pay attention to the fact that the literatures of the past ten years at home and abroad are included in this study,so there are some differences between the prosthesis materials and internal fixation materials used by the research objects,and the intraoperative injuries are different due to different operators,which will have a certain impact on this study.Therefore,more prospective,randomized,controlled studies are needed to further confirm. |
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