Ferguson D O, Shanbhag V, Hedley H, Reichert I, Lipscombe S, Davis T R C
Department of Trauma and Orthopaedic Surgery, Nottingham University Hospitals, Nottingham, UK.
Department of Trauma and Orthopaedic Surgery, Nottingham University Hospitals, Nottingham, UK
J Hand Surg Eur Vol. 2016 Jun;41(5):492-500. doi: 10.1177/1753193415604778. Epub 2015 Sep 30.
This systematic review assesses the quality and outcomes of published articles concerning bone graft surgery for scaphoid fracture non-union. Searches of the CENTRAL, MEDLINE, EMBASE, CINAHL and AMED databases captured 2710 articles. Each article was screened and 144 met our inclusion criteria. Data regarding source, study design, population, intervention, comparator and outcomes were extracted. There were 5464 scaphoid non-union outcomes within the 144 studies. Mean reported union rates for vascularized and non-vascularized bone graft were 84% and 80%, respectively. Avascular necrosis was diagnosed in several ways and, when present, the vascularized bone graft union rate was 74% compared with 62% with non-vascularized bone graft. Reported union rates vary considerably. These differences may be due to patient factors, fracture factors, treatment factors or study design failures or bias. We recommend that future researchers take into account the deficiencies of previous studies and use the suggested minimum data set in future studies.
II.
本系统评价评估了已发表的有关舟骨骨折不愈合骨移植手术的文章的质量和结果。检索CENTRAL、MEDLINE、EMBASE、CINAHL和AMED数据库共获得2710篇文章。对每篇文章进行筛选，144篇符合纳入标准。提取有关来源、研究设计、人群、干预措施、对照和结果的数据。144项研究中有5464例舟骨不愈合结果。报道的带血管蒂骨移植和不带血管蒂骨移植的平均愈合率分别为84%和80%。缺血性坏死有多种诊断方式，存在缺血性坏死时，带血管蒂骨移植的愈合率为74%，而不带血管蒂骨移植为62%。报道的愈合率差异很大。这些差异可能归因于患者因素、骨折因素、治疗因素或研究设计缺陷或偏倚。我们建议未来的研究者考虑既往研究的不足，并在未来研究中使用建议的最小数据集。
II级。
