Geoghegan Luke, Scarborough Alexander, Rodrigues Jeremy N, Hayton Mike J, Horwitz Maxim D
Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.
Kings College NHS Foundation Trust, London, UK.
Orthop J Sports Med. 2021 Feb 23;9(2):2325967120980013. doi: 10.1177/2325967120980013. eCollection 2021 Feb.
Fractures of the metacarpals and phalanges account for more than half of all upper extremity fractures sustained by competitive athletes.
To determine which management strategy is best for expediting return to preinjury levels of competition in adult athletes with metacarpal and/or phalangeal fractures.
Systematic review; Level of evidence, 4.
A methodology compliant with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was used. A custom search strategy was designed and applied to MEDLINE and In-Process, Embase, EMCARE, and CINAHL.
Overall, 3135 records were identified, of which 8 met full inclusion criteria. All patients returned to preinjury levels of competition, at a mean of 30.6 days for phalangeal fractures and 21.9 days for metacarpal fractures. Meta-analysis demonstrated delayed return-to-sport time for operatively managed metacarpal fractures as compared with nonoperatively managed ones (28.5 vs 22.0 days). All studies were of fair or poor quality, and none were randomized.
Optimal management strategies for athletes with metacarpal and phalangeal fractures remain equivocal. Injury, treatment, and sport-specific factors may confound results and preclude accurate estimation of optimal treatment strategies at present.
掌骨和指骨骨折占竞技运动员上肢骨折的一半以上。
确定哪种治疗策略最有利于成年掌骨和/或指骨骨折运动员恢复到伤前的比赛水平。
系统评价；证据等级，4级。
采用符合PRISMA（系统评价和Meta分析的首选报告项目）的方法。设计了一个定制的检索策略，并应用于MEDLINE及在研、Embase、EMCARE和CINAHL数据库。
共识别出3135条记录，其中8条符合全部纳入标准。所有患者均恢复到伤前的比赛水平，指骨骨折患者平均恢复时间为30.6天，掌骨骨折患者平均恢复时间为21.9天。Meta分析表明，与非手术治疗的掌骨骨折相比，手术治疗的掌骨骨折恢复运动时间延迟（28.5天对22.0天）。所有研究质量均为中等或较差，且均未进行随机分组。
掌骨和指骨骨折运动员的最佳治疗策略仍不明确。损伤、治疗和运动特定因素可能会混淆结果，目前无法准确估计最佳治疗策略。
