Treatment of acute scaphoid fractures: systematic review and meta-analysis.
نویسندگان
چکیده
Whether operative treatment is a better option than nonoperative treatment for acute nondisplaced or minimally displaced fractures of the scaphoid is controversial. The type of cast that should be used for nonoperative treatment is not known. We performed a systematic review and meta-analysis of randomized and quasirandomized trials to evaluate the effect of operative versus nonoperative treatment and the effect of different casting methods for nonoperative treatment of acute scaphoid fractures on nonunion rate, return to work, grip strength, range of wrist motion, complications, patient evaluation, and incidence of osteoarthritis. Two investigators assessed trial quality and extracted data. Operative treatment of acute nondisplaced or minimally displaced fractures of the scaphoid waist does not provide greater benefits regarding nonunion rate, return to work, grip strength, range of wrist motion, or patient satisfaction than cast immobilization; however, it causes more complications and, perhaps, a higher risk of scaphotrapezial osteoarthritis. There is no evidence from randomized trials to determine whether operative treatment is superior to nonoperative treatment for an acute proximal pole fracture of scaphoid bones. There is insufficient evidence to determine which type of cast should be used in nonoperative treatment of nondisplaced scaphoid fractures.
منابع مشابه
Acute fractures of the scaphoid bone: Systematic review and meta-analysis.
BACKGROUND The scaphoid fractures account for 50%-80% of all carpal bone fractures in young individuals. Non-union of the fracture occurs in approximately 5%-10% of undisplaced scaphoid fractures. Current management varies significantly among different places and surgeons. OBJECTIVES The purpose of this review is to investigate the evidence of the effectiveness and safety of various treatment...
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ورودعنوان ژورنال:
- Hand
دوره 5 4 شماره
صفحات -
تاریخ انتشار 2007