Meta analysis of surgical and conservative treatment of acute stable scaphoid lumbar fracture
Objective To systematically evaluate the efficacy of surgical and conservative treatment of acute undisplaced or displaced＜1 mm scaphoid lumbar fracture.Methods PubMed,Cochrane library,Embase,CBM,Wanfang database,China Journal full-text database(CNKI)and VIP database(from the establishment of the database to August 2023)were searched.Reports of surgical and conservative treatment of acute scaphoid lumbar fracture without displacement or displacement＜1 mm were studied.Data were extracted according to the fracture healing time,return to work time,wrist range of motion,grip strength,Disabilities of the Arm,Shoulder and Hand(DASH)score,bone nonunion rate and incidence of complications.Revman 5.4 was used for data analysis,and Stata 17.0 was used for sensitivity analysis.Results A total of 15 studies were included,comprising 12 randomized controlled studies and three case-control studies,involving a total of 1 221 patients,consisting of a surgical treatment group(n=611)and a conservative treatment group(n=610).Compared with the conservative treatment group,the surgical group had shorter fracture healing time(P＜0.05),earlier return to work(P＜0.05),greater wrist range of motion(P＜0.05)and greater grip strength(P＜0.05).The incidence of nonunion was lower(P＜0.05).There was no significant difference in DASH score or incidence of complications between the treatment groups(P＞0.05).Conclusion Surgical treatment of acute undisplaced or displaced＜1 mm scaphoid lumbar fracture results in better grip strength and wrist range of motion than conservative treatment,the fracture healing time and return to work time are shorter,and the incidence of nonunion is lower.The two treatments produced similar results in terms of DASH score and complications.
万方数据
维普
