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在需要强力握持的运动中孤立的钩骨骨折:综合文献综述

Isolated hook of hamate fracture in sports that require a strong grip comprehensive literature review.

作者信息

Kim Heejae, Kwon Bumsun, Kim Jihyun, Nam Kiyeun

机构信息

Departments of Physical Medicine and Rehabilitation, Dongguk University College of Medicine, Gyeonggi-do.

Department of Pediatrics, Dongguk University Ilsan Hospital, Goyang, Korea.

出版信息

Medicine (Baltimore). 2018 Nov;97(46):e13275. doi: 10.1097/MD.0000000000013275.

Abstract

BACKGROUND

The aim of the study was to report characteristics of isolated hook of hamate fractures related to sports that require a strong grip and to identify factors affecting early diagnosis and recovery period.

METHODS

A comprehensive literature search was conducted using MEDLINE, EMBASE, SCOPUS, Web of Science, the Cochrane Central Register of Controlled Trials, the World Health Organization International Clinical Trials Registry Platform, and the clinical trials registry and database of the US National Institutes of Health (ClinicalTrials.gov). There were no limits on the language or year of publication.This article included case reports and literature reviews for patients with isolated hook of hamate fractures related to sports that require a strong grip from 1977 to 2016.Two experienced reviewers extracted data from each study. The following data were extracted: sample size, patient's characteristics, cause of injury, injury side, time to diagnosis and symptoms, physical examination results, diagnostic work-up, treatment, complications, and recovery period.

RESULTS

A total of 21 case reports and literature reviews with 120 patients satisfied our inclusion criteria. There was no significant difference in the time to diagnosis between the group before computed tomography (CT) was widely used and the group after CT was widely used. Recovery period showed a positive relationship with age (coefficient = 0.418, P < .01), time from injury to diagnosis or surgery (coefficient = 0.206, P < .05), and type of athlete (coefficient = 0.270, P < .01). On multiple stepwise regression analysis, recovery period was significantly associated with age (β = 0.418, P = .00), but not with time from injury to diagnosis or surgery.

CONCLUSIONS

Advance in diagnostic techniques does not guarantee early diagnosis of hook of hamate fractures. Strong suspicion of the disease with physical examination and carefully hearing patient's history are important for early diagnosis and management for patients with hook of hamate fractures.

摘要

背景

本研究旨在报告与需要强力握持的运动相关的孤立性钩骨钩骨折的特征,并确定影响早期诊断和恢复期的因素。

方法

使用MEDLINE、EMBASE、SCOPUS、科学网、Cochrane对照试验中央注册库、世界卫生组织国际临床试验注册平台以及美国国立卫生研究院的临床试验注册库和数据库(ClinicalTrials.gov)进行全面的文献检索。对语言和发表年份没有限制。本文纳入了1977年至2016年与需要强力握持的运动相关的孤立性钩骨钩骨折患者的病例报告和文献综述。两名经验丰富的评审员从每项研究中提取数据。提取了以下数据:样本量、患者特征、损伤原因、损伤侧、诊断时间和症状、体格检查结果、诊断检查、治疗、并发症和恢复期。

结果

共有21篇病例报告和文献综述,涉及120例患者,符合我们的纳入标准。在计算机断层扫描(CT)广泛应用之前的组和CT广泛应用之后的组之间,诊断时间没有显著差异。恢复期与年龄呈正相关(系数=0.418,P<.01),与受伤至诊断或手术的时间呈正相关(系数=0.206,P<.05),与运动员类型呈正相关(系数=0.270,P<.01)。在多元逐步回归分析中,恢复期与年龄显著相关(β=0.418,P=.00),但与受伤至诊断或手术的时间无关。

结论

诊断技术的进步并不能保证钩骨钩骨折的早期诊断。体格检查时对该病的高度怀疑并仔细听取患者病史对于钩骨钩骨折患者的早期诊断和管理很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8462/6257646/7647a21eb569/medi-97-e13275-g001.jpg

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