[Clinical effects between cannulated screw and bone plate internal fixation for humeral tuberosity fracture:a Meta analysis].

ABSTRACT

OBJECTIVE: To compare clinical effect of cannulated screw and bone plate for the treatment of humeral fracture of greater tuberosity. METHODS: From January 2010 to January 2020, clinical trial literatures on the treatment of humeral tuberosity fractures with cannulated screw and bone plate were searched by PubMed, EMbase, Cochrane Library, Wanfang, CNKI, CBM Database, VIP Database and other databases. Independent literature screening, quality evaluation, and data extraction were performed according to inclusion and exclusion criteria. Revman5.2 software was used to perform Meta analysis. RESULTS: Totally 5 clinical randomized controlled trials and 12 cohort studies were selected, including 1 068 patientsin which 559 patients were treated by cannulated screw internal fixation and 509 patients treated by bone plate internal fixation. Meta analysis resluts showed that there were satistical differences in operation time[MD=-23.03, 95% CI(-29.69, -16.36), P<0.000 1], blood loss[MD=-36.39, 95% CI(-53.73, -19.04), P<0.000 1], hospital stay[MD=-1.86, 95%CI(-3.09, -0.64), P=0.003], fracture healing time [MD=-2.23, 95% CI (-4.27, -0.18), P=0.03], postoperative incidence of infection [OR=0.17, 95%CI (0.03, 0.97), P=0.05], failure rate of internal fixation [OR=3.56, 95% CI (1.29, 9.81), P=0.01] bwteen two groups. While there were no differences in postoperative visual analogue scale (VAS)[MD=-1.34, 95% CI (-2.77, 0.09), P=0.07], American Shoulder and Elbow Surgeons(ASES)[MD=0.26, 95% CI(-6.43, 6.96), P=0.94], Constant shoulder score [MD=-4.05, 95% CI(-8.51, 0.42), P=0.08], excellent rate of Constant shoulder score[MD=-1.30, 95% CI(0.46, 3.72), P=0.62], excellent rate of Neer shoulder joint score[OR=2.04, 95% CI(0.97, 4.28), P=0.06], total complication rate[OR=1.50, 95% CI (0.42, 5.35), P=0.53], incidence of postoperative pain[OR=0.74, 95% CI(0.04, 14.49), P=0.84] and incidence of postoperative acromion syndrome [OR=0.88, 95% CI (0.02, 40.63), P=0.95] between two groups. CONCLUSION: Compared with bone plate, cannulated screw for the treatment of humeral fracture of greater tuberosity has advantages of shorter opertaion time, less blood loss, shorter hospital stay, lower incidence rate of postopertaive infection, and more benefit for fracture healing.