Operative Versus Conservation Treatment Of Acute Undisplaced Scaphoid Fractures-A Meta An Analysis

ObjectiveCompare surgery and conservative treatment of adult non-displaced scaphoid fracture for short-term and long-term efficacy by Meta analysis.MethodsWe searched the specialized trials registered in Medline, EMbase, Cochrane Library and Cochrane Collaboration Musculoskeletal Group, the Chinese Biomedical Literature Database (CBM), wanfangdata and so on. We also hand-searched some Chinese orthopedics journals. Randomized controlled trials (RCTs) of surgical treatment versus conservative treatment for adult acute non-displaced scaphoid fractures were included. The extraction of data and the methodological assessment of included RCTs were performed by two reviewers independently. RevMan software was used to carry out meta-analysis.ResultsSix RCTs including 359 patients met the inclusion criteria. Compared with conservative treatment, both in healing time and that taken before returning to work was shorter in the surgical treatment group., and patient's grip strength is recovered faster for the first year in operation group, which is more likely to progress osteoarthritis. But the ROM in conservation group is better.ConclusionsCompared with conservative treatment for adult acute non-displaced scaphoid fractures, surgical treatment could decrease the time of union, decrease the time of returning to work, and improve grip strength for short-term. Contrary, it also improve the incidence of osteoarthritis, and it is worse in ROM for long-term.