Chen Shao, Zhang Caihua, Jiang Bo, Mi Yunfeng, Zhu Yingchun, Jia Xuewen
Department of Orthopedics, Ningbo First Hospital, 59 Liuting Street, Ningbo, Zhejiang, China.
World J Surg. 2023 Mar;47(3):611-620. doi: 10.1007/s00268-022-06833-1. Epub 2022 Dec 9.
This meta-analysis aimed to investigate the effectiveness of conservative and surgical treatments of scaphoid fracture.
The literature databases of Pubmed, Cochrane library, and Embase were searched in March 2022. This work extracted the data based on healing time, grip strength, range of wrist motion, nonunion, time before returning to work, and complications (including persistent pain, malunion of the fracture, wound infection, scar sensitivity, hypertrophic scar, and implant-related complications). Stata 14.0 software was used for statistical analysis.
Twelve RCTs studies met our inclusion criteria. The surgical group had a shorter healing-time and time before returning to work than the conservative group. In addition, the surgical group had significantly better grip strength and range of wrist motion than the conservative group (P < 0.01). However, there was no significant difference between nonunion (P = 0.538) and complications (P = 0.661) between the two groups.
This meta-analysis showed that surgical treatment of scaphoid fracture achieved better grip strength and range of wrist motion, and had a lower healing time and time before returning to work than the conservative treatment. The two treatments had similar results in nonunion and complications. Further RCTs were required for the research.
本荟萃分析旨在探讨舟骨骨折保守治疗和手术治疗的有效性。
于2022年3月检索了PubMed、Cochrane图书馆和Embase的文献数据库。这项研究基于愈合时间、握力、腕关节活动范围、骨不连、恢复工作前的时间以及并发症（包括持续性疼痛、骨折畸形愈合、伤口感染、瘢痕敏感性、增生性瘢痕和植入物相关并发症）提取数据。使用Stata 14.0软件进行统计分析。
12项随机对照试验研究符合纳入标准。手术组的愈合时间和恢复工作前的时间比保守组短。此外，手术组的握力和腕关节活动范围明显优于保守组（P < 0.01）。然而，两组之间的骨不连（P = 0.538）和并发症（P = 0.661）没有显著差异。
本荟萃分析表明，舟骨骨折的手术治疗在握力和腕关节活动范围方面取得了更好的效果，并且愈合时间和恢复工作前的时间比保守治疗短。两种治疗方法在骨不连和并发症方面的结果相似。该研究需要进一步的随机对照试验。
