| Title | Treatment of Acute Scaphoid Fractures: Systematic Review and Meta-analysis. | | Author(s) | Yin Z, Zhang J, Kan S, Wang P | | Institution | From the *Department of Hand and Microsurgery, Tianjin Hospital, Tianjin, China; and the †Department of Orthopaedics, General Hospital of Tianjin Medical University, Tianjin, China. | | Source | Clin Orthop Relat Res 2007 Feb 15. | | Abstract | Whether operative treatment is a better option than nonoperative treatment for acute nondisplaced or minimally displaced fractures of the scaphoid is controversial. The type of cast that should be used for nonoperative treatment is not known. We performed a systematic review and meta-analysis of randomized and quasirandomized trials to evaluate the effect of operative versus nonoperative treatment and the effect of different casting methods for nonoperative treatment of acute scaphoid fractures on nonunion rate, return to work, grip strength, range of wrist motion, complications, patient evaluation, and incidence of osteoarthritis. Two investigators assessed trial quality and extracted data. Operative treatment of acute nondisplaced or minimally displaced fractures of the scaphoid waist does not provide greater benefits regarding nonunion rate, return to work, grip strength, range of wrist motion, or patient satisfaction than cast immobilization; however, it causes more complications and, perhaps, a higher risk of scaphotrapezial osteoarthritis. There is no evidence from randomized trials to determine whether operative treatment is superior to nonoperative treatment for an acute proximal pole fracture of scaphoid bones. There is insufficient evidence to determine which type of cast should be used in nonoperative treatment of nondisplaced scaphoid fractures.Level of Evidence: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 17310931 |
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