Carpus: Trauma

Surgical Compared with Conservative Treatment for Acute Nondisplaced or Minimally Displaced Scaphoid Fractures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Buijze GA, Doornberg JN, Ham JS, et al (Academic Med Centre, Amsterdam, The Netherlands; Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands; et al) J Bone Joint Surg Am 92:1534-1544, 2010^§

Abstract

Background

There is a current trend in orthopaedic practice to treat nondisplaced or minimally displaced fractures with early open reduction and internal fixation instead of cast immobilization. This trend is not evidence-based. In this systematic review and meta-analysis, we pool data from trials comparing surgical and conservative treatment for acute nondisplaced and minimally displaced scaphoid fractures, thus aiming to summarize the best available evidence.

Methods

A systematic literature search of the medical literature from 1966 to 2009 was performed. We selected eight randomized controlled trials comparing surgical with conservative treatment for acute nondisplaced or minimally displaced scaphoid fractures in adults. Data from included studies were pooled with use of fixed-effects and random-effects models with standard mean differences and risk ratios for continuous and dichotomous variables, respectively. Heterogeneity across studies was assessed with calculation of the I² statistic.

Results

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