Management of Displaced Metacarpal Shaft Fractures: A Systematic Review and Meta-analysis.
Hand fractures
conservative management
metacarpal shaft fractures
operative management
shortening
Journal
JPRAS open
ISSN: 2352-5878
Titre abrégé: JPRAS Open
Pays: Netherlands
ID NLM: 101680420
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
17
08
2023
accepted:
01
10
2023
medline:
3
11
2023
pubmed:
3
11
2023
entrez:
3
11
2023
Statut:
epublish
Résumé
Affecting mainly the working population, metacarpal shaft fractures account for up to 31% of hand fractures. To manage this entity, conservative management can be equal to operative management. However, surgeons tend to favor operative management in order to reduce the rate of complications, such as shortening and malunion. This meta-analysis was conducted to compare conservative to operative management of displaced metacarpal shaft fractures. PubMed, Cochrane, and Google Scholar (pages 1-20) were searched until August 2023. The clinical outcomes consisted of postoperative shortening, Disabilities of Arm, Shoulder, and Hand (DASH) score, and mean grip strength. Only three studies were included in this meta-analysis. Operative management was shown to reduce postoperative shortening (p<0.00001). However, conservative management had a better postoperative DASH score (p=0.001). Better DASH scores were seen in the conservative group, but there was a higher postoperative shortening. However, studies have shown that the shortening has no effect on the functional outcome. Nevertheless, more randomized controlled studies and cost-effectiveness studies are needed to confirm these findings.
Sections du résumé
Background
UNASSIGNED
Affecting mainly the working population, metacarpal shaft fractures account for up to 31% of hand fractures. To manage this entity, conservative management can be equal to operative management. However, surgeons tend to favor operative management in order to reduce the rate of complications, such as shortening and malunion. This meta-analysis was conducted to compare conservative to operative management of displaced metacarpal shaft fractures.
Methods
UNASSIGNED
PubMed, Cochrane, and Google Scholar (pages 1-20) were searched until August 2023. The clinical outcomes consisted of postoperative shortening, Disabilities of Arm, Shoulder, and Hand (DASH) score, and mean grip strength.
Results
UNASSIGNED
Only three studies were included in this meta-analysis. Operative management was shown to reduce postoperative shortening (p<0.00001). However, conservative management had a better postoperative DASH score (p=0.001).
Conclusion
UNASSIGNED
Better DASH scores were seen in the conservative group, but there was a higher postoperative shortening. However, studies have shown that the shortening has no effect on the functional outcome. Nevertheless, more randomized controlled studies and cost-effectiveness studies are needed to confirm these findings.
Identifiants
pubmed: 37920285
doi: 10.1016/j.jpra.2023.10.002
pii: S2352-5878(23)00063-3
pmc: PMC10618610
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
163-172Informations de copyright
© 2023 The Authors.
Déclaration de conflit d'intérêts
We declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Références
J Orthop Trauma. 1997 Aug;11(6):441-5
pubmed: 9314153
J Hand Surg Eur Vol. 2015 Jan;40(1):33-41
pubmed: 25217094
J Hand Surg Eur Vol. 2010 Nov;35(9):725-9
pubmed: 20659966
J Hand Surg Eur Vol. 2015 Jan;40(1):59-62
pubmed: 24963083
Plast Surg (Oakv). 2018 Aug;26(3):148-153
pubmed: 30148125
BMJ. 2016 Oct 12;355:i4919
pubmed: 27733354
J Hand Surg Eur Vol. 2008 Dec;33(6):732-9
pubmed: 18936129
J Hand Surg Am. 1999 Jul;24(4):835-44
pubmed: 10447177
Plast Reconstr Surg. 2014 May;133(5):1252-1260
pubmed: 24776556
J Hand Surg Am. 1998 Sep;23(5):827-32
pubmed: 9763256
J Hand Surg Br. 2003 Oct;28(5):491-5
pubmed: 12954264
J Bone Joint Surg Am. 2023 Jan 18;105(2):98-106
pubmed: 36455163