Carpus

Nonoperative Treatment for Acute Scaphoid Fractures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Doornberg JN, Buijze GA, Ham SJ, et al (Academic Med Centre, Amsterdam, the Netherlands; Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; et al) J Trauma 71:1073-1081, 2011^§

Abstract

Background

Recommendations for cast immobilization of acute scaphoid fractures vary substantially. We reviewed data from randomized controlled trials comparing nonoperative treatment methods for acute scaphoid fractures to determine the best available evidence.

Methods

A systematic search of the medical literature from 1966 to 2010 was performed. Two authors independently screened titles and abstracts, reviewed articles, assessed methodological quality according to the Grading of Recommendations Assessment Development and Evaluation system, and extracted data. The primary outcome parameter was nonunion. Data were pooled using random-effects models with standard mean differences for continuous and risk ratios for dichotomous variables, respectively. Heterogeneity across studies was assessed with calculation of the I² statistic.

Results

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