Schädel-Höpfner M, Windolf J, Antes G, Sauerland S, Diener M K
Department of Trauma and Hand Surgery, University Hospital, Düsseldorf, Germany.
J Hand Surg Eur Vol. 2008 Apr;33(2):110-7. doi: 10.1177/1753193407087510.
A detailed literature search was performed to investigate whether the increasing importance of evidence-based hand surgery is reflected in the actual status of Cochrane reviews. Fourteen Cochrane reviews were found and evaluated. Of these, five reviews were in the field of distal radial fractures and four concerned carpal tunnel syndrome. Cochrane reviews were also found for antibiotic treatment, rehabilitation after flexor tendon injuries, mallet finger injuries, little finger metacarpal neck fractures and thumb joint arthritis. All 14 reviews were compromised by methodological flaws and significant clinical heterogeneity of the included studies. Within most reviews the underlying evidence was insufficient and only a very limited number of clinical recommendations could be made. In conclusion, the existing Cochrane reviews in the field of hand surgery show both an increasing interest in establishing systematically summarised knowledge and an enormous demand for good-quality randomised controlled trials.
进行了详细的文献检索，以调查循证手外科日益增长的重要性是否反映在Cochrane系统评价的实际状况中。共检索到并评估了14篇Cochrane系统评价。其中，5篇评价涉及桡骨远端骨折领域，4篇涉及腕管综合征。还检索到了关于抗生素治疗、屈指肌腱损伤后康复、锤状指损伤、小指掌骨颈骨折和拇指关节关节炎的Cochrane系统评价。所有14篇评价均存在方法学缺陷以及纳入研究显著的临床异质性问题。在大多数评价中，基础证据不足，仅能提出非常有限的临床建议。总之，手外科领域现有的Cochrane系统评价既显示出对建立系统总结知识的兴趣日益增加，也显示出对高质量随机对照试验的巨大需求。
