Department of Hand Surgery, Wuxi 9th People's Hospital Affiliated to Soochow University, Wuxi, China.
J Orthop Surg Res. 2024 Feb 20;19(1):149. doi: 10.1186/s13018-024-04611-4.
This study aimed to systematically compare the efficacy and safety of arthroscopic wafer procedure (AWP) versus ulnar shortening osteotomy (USO) for ulnar impaction syndrome (UIS) treatment.
All the studies included in this meta-analysis compared the efficacy of AWP to USO for UIS and were acquired through a comprehensive search across multiple databases. The meta-analysis was performed by calculating the effect sizes with the Cochrane Collaboration's RevMan 5.4 software.
A total of 8 articles were included in this analysis, comprising 148 cases in the AWP group and 163 cases in the USO group. The pooled estimates indicated no significant differences in combined Darrow's Criteria or Modified Mayo Wrist Score, Modified Mayo Wrist Score, DASH scores, grip strength, VAS score, and postoperative ulnar variation. On the other hand, the patients in the AWP group exhibited fewer complications (OR = 0.17, 95%CI 0.05-0.54, P = 0.003) and a lower reoperation rate (OR = 0.12, 95%CI 0.05-0.28, P < 0.00001) than those in the USO group.
The two surgical techniques were both effective in treating UIS but the AWP group showed fewer complications and a lower reoperation rate. Therefore, AWP may present a superior alternative for UIS treatment.
本研究旨在系统比较关节镜下 wafer 手术(AWP)与尺骨缩短截骨术(USO)治疗尺骨撞击综合征(UIS)的疗效和安全性。
本荟萃分析纳入的所有研究均比较了 AWP 与 USO 治疗 UIS 的疗效,并通过对多个数据库的全面检索获得。使用 Cochrane 协作 RevMan 5.4 软件计算效应量进行荟萃分析。
共纳入 8 篇文章,AWP 组 148 例,USO 组 163 例。汇总估计表明,Darrow 综合标准或改良 Mayo 腕关节评分、改良 Mayo 腕关节评分、DASH 评分、握力、VAS 评分和术后尺骨变异无显著差异。另一方面,AWP 组患者的并发症更少(OR=0.17,95%CI 0.05-0.54,P=0.003),再次手术率更低(OR=0.12,95%CI 0.05-0.28,P<0.00001)。
两种手术技术治疗 UIS 均有效,但 AWP 组并发症更少,再次手术率更低。因此,AWP 可能是治疗 UIS 的更好选择。