腕管松解术后支具固定是否有益？系统评价和荟萃分析。
Are there any benefits for post-operative splinting after carpal tunnel release? A systematic review and meta-analysis.
机构信息
Department of Neurosurgery, Rutgers University New-Brunswick, Moncton, NJ, USA.
Clinical Research Development Center, Taleghani and Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
出版信息
BMC Musculoskelet Disord. 2024 Feb 21;25(1):163. doi: 10.1186/s12891-024-07230-6.
BACKGROUND
There is a controversy on the effectiveness of post-operating splinting in patients with carpal tunnel release (CTR) surgery. This study aimed to systematically evaluate various outcomes regarding the effectiveness of post-operating splinting in CTR surgery.
METHODS
Multiple databases, including PubMed, EMBASE, CINAHL, Web of Science, and Cochrane, were searched for terms related to carpal tunnel syndrome. A total of eight studies involving 596 patients were included in this meta-analysis. The quality of studies was evaluated, and their risk of bias was calculated using the methodological index for non-randomized studies (MINORS) and Cochrane's collaboration tool for assessing the risk of bias in randomized controlled trials. Data including the visual analogue scale (VAS), pinch strength, grip strength, two-point discrimination, symptom severity score (SSS), and functional status scale (FSS) were extracted.
RESULTS
Our analysis showed no significant differences between the splinted and non-splinted groups based on the VAS, SSS, FSS, grip strength, pinch strength, and two-point discrimination. The calculated values of the standardized mean difference (SMD) or the weighted mean difference (WMD) and a 95% confidence interval (CI) for different variables were as follows: VAS [SMD = 0.004, 95% CI (-0.214, 0.222)], pinch strength [WMD = 1.061, 95% CI (-0.559, 2.681)], grip strength [SMD = 0.178, 95% CI (-0.014, 0.369)], SSS [WMD = 0.026, 95% CI (- 0.191, 0.242)], FSS [SMD = 0.089, 95% CI (-0.092, 0.269)], and the two-point discrimination [SMD = 0.557, 95% CI (-0.140, 1.253)].
CONCLUSIONS
Our findings revealed no statistically significant differences between the splinted and non-splinted groups in terms of the VAS, SSS, FSS, grip strength, pinch strength, and two-point discrimination. These results indicate that there is no substantial evidence supporting a significant advantage of post-operative splinting after CTR.
背景
在腕管松解术后患者中，术后夹板固定的有效性存在争议。本研究旨在系统评估腕管松解术后夹板固定的各种疗效。
方法
通过检索 PubMed、EMBASE、CINAHL、Web of Science 和 Cochrane 等多个数据库，查找与腕管综合征相关的术语。对纳入的八项研究（共 596 例患者）进行质量评估，并使用非随机研究方法学指数（MINORS）和 Cochrane 协作工具评估随机对照试验的偏倚风险。提取视觉模拟评分（VAS）、捏力、握力、两点辨别觉、症状严重程度评分（SSS）和功能状态评分（FSS）等数据。
结果
根据 VAS、SSS、FSS、握力、捏力和两点辨别觉，夹板固定组与非夹板固定组之间无显著差异。不同变量的标准化均数差（SMD）或加权均数差（WMD）和 95%置信区间（CI）的计算值如下：VAS [SMD = 0.004，95%CI（-0.214，0.222）]、捏力 [WMD = 1.061，95%CI（-0.559，2.681）]、握力 [SMD = 0.178，95%CI（-0.014，0.369）]、SSS [WMD = 0.026，95%CI（-0.191，0.242）]、FSS [SMD = 0.089，95%CI（-0.092，0.269）]和两点辨别觉 [SMD = 0.557，95%CI（-0.140，1.253）]。
结论
在 VAS、SSS、FSS、握力、捏力和两点辨别觉方面，夹板固定组与非夹板固定组之间无统计学差异。这些结果表明，没有确凿证据支持腕管松解术后使用术后夹板固定有显著优势。
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