Department of Hand Surgery, Wuxi 9th People's Hospital Affiliated to Soochow University, Wuxi, China.
Medicine (Baltimore). 2021 Mar 19;100(11):e24996. doi: 10.1097/MD.0000000000024996.
Though the previous studies had described various surgical techniques for the treatment of mallet finger injuries, consensus on which technique was the most effective and appropriate surgical methods had not yet reached. This review aimed to systematically compare the effectiveness and safety of the treatment for mallet finger injuries via Kirschner wire fixation versus suture anchor technique to recommend an optimum option.
All literatures published until December 31, 2019 compared Kirschner wire fixation versus suture anchor technique to treat mallet finger were acquired through a comprehensive search in multiple databases. A meta-analysis was performed by the Cochrane Collaboration's RevMan 5.3 software.
A total of 8 trials with 362 cases consisted of 4 randomized controlled trials and 4 prospective studies. The results suggested that the groups treated with kirschner wire fixation experienced more significant advantage in less complications than suture anchor groups (P < .05). On the other hand, no significant differences were found in terms of the total active range motion of the distal interphalangeal joint, the average distal interphalangeal joint extensor lag, Visual Analogue Scale scores, recurrence, as well as functional assessment at the final follow-up (P > .05, respectively) between the two surgical procedures.
No obvious superiority were shown for the effectiveness between the two surgical interventions based on the above results. But in view of the less economic spending and complications, Kirschner wire fixation should be a better alternative relative to the suture anchor technique for inevitable surgical treatment of mallet finger lesions. However, a prudent attitude is still necessary to choose the two operative managements before a large sample and high-quality randomized controlled trials had been performed.
尽管之前的研究已经描述了治疗锤状指损伤的各种手术技术，但哪种技术最有效和最合适的手术方法尚未达成共识。本综述旨在系统比较克氏针固定与缝线锚钉技术治疗锤状指损伤的效果和安全性，以推荐最佳选择。
通过在多个数据库中全面搜索，获取截至 2019 年 12 月 31 日发表的比较克氏针固定与缝线锚钉技术治疗锤状指损伤的所有文献。采用 Cochrane 协作的 RevMan 5.3 软件进行荟萃分析。
共有 8 项试验（362 例）纳入研究，包括 4 项随机对照试验和 4 项前瞻性研究。结果表明，与缝线锚钉组相比，克氏针固定组在并发症发生率方面具有更显著的优势（P<0.05）。另一方面，两组在远侧指间关节总主动活动度、平均远侧指间关节伸肌迟滞、视觉模拟评分、复发率以及最终随访时的功能评估方面差异无统计学意义（P>0.05）。
根据上述结果，两种手术干预的效果没有明显优势。但是，考虑到较少的经济支出和并发症，与缝线锚钉技术相比，克氏针固定对于不可避免的锤状指病变的手术治疗应是更好的选择。然而，在进行大规模、高质量的随机对照试验之前，仍需谨慎选择这两种手术治疗方法。
