短腿石膏与可移动矫形支具治疗假性琼斯撕脱骨折的疗效比较：系统评价和荟萃分析。

Short leg cast versus orthotic removable support for the management of pseudo-Jones avulsion fracture: A systematic review and meta-analysis.

机构信息

College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.

出版信息

Injury. 2022 Feb;53(2):739-745. doi: 10.1016/j.injury.2021.11.032. Epub 2021 Nov 16.

DOI:10.1016/j.injury.2021.11.032

PMID:34838261

Abstract

BACKGROUND

The fifth metatarsal base avulsion fracture (i.e., Pseudo-Jones fracture) is one of the most common foot fractures. The management of pseudo-Jones fractures could be carried out surgically or conservatively. This systematic review and meta-analysis aimed to provide an update about the efficacy of orthotic removable support compared to short-leg casting for individuals with pseudo-Jones fracture.

METHODS

We searched Embase, Medline, and Cochrane Central register of Controlled Trials (CENTRAL) for randomized controlled trials (RCTs) that compared the clinical outcomes of orthotic removable support and short-leg cast for adult individuals with a fifth metatarsal base avulsion fracture. We used 95% as a confidence level and P <0.05 as a threshold. The standardized mean difference (SMD) was used for the continuous outcomes, and the risk ratio (RR) was used for the dichotomous outcomes.

RESULTS

A total of 6 RCTs incorporating 403 individuals out were deemed eligible. There was no significant difference between orthotic removable support and short-leg casting regarding AOFAS score (standardized mean difference (SMD)= 0.31, 95% CI -0.17 to 0.8), pain on VAS score (SMD= -0.08, 95% CI -0.39 to 0.22), VAS-FA score (SMD= 0.22, 95% CI -0.19 to 0.62) EQ-5D VAS score, and non-union rate (RR=0.37, 95% CI 0.05 to 2.74).

CONCLUSION

The current meta-analysis reveals that there is no difference between orthotic removable support and short-leg casting for the conservative management of individuals sustaining pseudo-Jones fracture.

摘要

背景

第五跖骨基底撕脱骨折（即假性琼斯骨折）是最常见的足部骨折之一。假性琼斯骨折的治疗可以采用手术或保守治疗。本系统评价和荟萃分析旨在提供更新的信息，比较矫形可移动支撑与短腿石膏治疗假性琼斯骨折患者的疗效。

方法

我们在 Embase、Medline 和 Cochrane 对照试验中心注册库（CENTRAL）中搜索了比较矫形可移动支撑与短腿石膏治疗第五跖骨基底撕脱骨折成人患者的临床结局的随机对照试验（RCT）。我们使用 95%置信水平和 P <0.05 作为阈值。连续结局采用标准化均数差（SMD），二分类结局采用风险比（RR）。

结果

共有 6 项 RCT 纳入了 403 名符合条件的患者。矫形可移动支撑与短腿石膏在 AOFAS 评分（SMD=0.31，95%CI -0.17 至 0.8）、VAS 疼痛评分（SMD=-0.08，95%CI -0.39 至 0.22）、VAS-FA 评分（SMD=0.22，95%CI -0.19 至 0.62）、EQ-5D VAS 评分和非愈合率（RR=0.37，95%CI 0.05 至 2.74）方面没有显著差异。