A Meta-analysis Study of Acute Undisplaced Scaphoid Fractures Management
European Journal of Molecular & Clinical Medicine,
2021, Volume 8, Issue 4, Pages 2180-2187
AbstractManaging scaphoid fractures varies among hospitals and depends upon local preferences and protocols. This study aimed to perform a meta-analysis to compare the results of conservative management of acute scaphoid fracture versus the surgical management. Patients and methods: This meta-analysis study restricted to RCT, and comparative studies, either prospective or retrospective, which studied the outcome of percutaneous fixation by cannulated screw versus conservative treatment with casting in patients with acute undisplaced scaphoid fractures.Results: We filtered 250 record; leaving 9 studies that met all inclusion criteria. The total number of patients in all the included studies was 589 patients; 308 of them had conservative cast management (conservative group), and 281 patients had percutaneous fixation by cannulated screw (surgical group).We found all 9 studies reported successful union rate, with total number of patients (N=589). Our meta-analysis study showed that; overall (successful union rate) in surgical group was 98.4%, while in conservative group was 92.8%. Meta-analysis of (non-union “failure”), fixed and randomeffects models showed highly significant decrease in non-union “failure” rate in the experimental group compared to conservative group (p=0.002, p= 0.019 respectively).Conclusion: Surgical management of non-displaced scaphoid fractures, was considered superior to conservative cast management, in union rate, early time of union, but the 2 approaches were comparable regarding the rate of complications.
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