Samargandi Osama A, Alyouha Sarah, Larouche Patricia, Corkum Joseph P, Kemler Marius A, Tang David T
Division of Plastic and Reconstructive Surgery, College of Medicine, Dalhousie University, Halifax, Nova Scotia; Division of Plastic Surgery, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Division of Plastic and Reconstructive Surgery, College of Medicine, Dalhousie University, Halifax, Nova Scotia.
J Hand Surg Am. 2017 Oct;42(10):839.e1-839.e10. doi: 10.1016/j.jhsa.2017.06.100. Epub 2017 Sep 1.
To determine the role of night orthosis use after surgical correction of Dupuytren contracture.
We searched MEDLINE, EMBASE, CINAHL, AMED, OTSeeker, and CENTRAL for articles published from inception of the databases to August 2015. Assessment was undertaken by 2 independent reviewers (O.A.S. and S.A.). Methodological quality of randomized controlled trials was assessed using the Cochrane risk of bias tool and the Newcastle-Ottawa instrument.
Seven studies met the standard for inclusion in this review. A total of 659 patients across these 7 studies were included in the analysis, with follow-up ranging from 3 to 72 months. None of the included studies assessed recurrence. The analysis revealed no significant improvement in range of motion of hand joints for patients who received a static night orthosis after Dupuytren surgery compared with patients without an orthosis. Similarly, no differences were found in patient-reported functional status across the 2 groups.
The current literature does not appear to support the use of static night orthosis in addition to hand therapy after surgical correction of Dupuytren contracture.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
确定在Dupuytren挛缩症手术矫正后使用夜间矫形器的作用。
我们检索了MEDLINE、EMBASE、CINAHL、AMED、OTSeeker和CENTRAL数据库,查找从数据库建立至2015年8月发表的文章。由2名独立评审员(O.A.S.和S.A.)进行评估。使用Cochrane偏倚风险工具和纽卡斯尔-渥太华工具评估随机对照试验的方法学质量。
7项研究符合纳入本综述的标准。这7项研究共纳入659例患者进行分析,随访时间为3至72个月。纳入的研究均未评估复发情况。分析显示,与未使用矫形器的患者相比,Dupuytren手术后接受静态夜间矫形器治疗的患者手部关节活动范围无显著改善。同样,两组患者报告的功能状态也无差异。
目前的文献似乎不支持在Dupuytren挛缩症手术矫正后,除手部治疗外使用静态夜间矫形器。
研究类型/证据水平:治疗性IV级。