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Abstract

BACKGROUND:

There are some clinical experiences for percutaneous screw insert fixation and cast immobilization treatment for acute nondisplaced carpal scaphoid fracture. However, relevant evidence-based medicine studies are rare.

OBJECTIVE:

To assess the effectiveness and safety of percutaneous screw insert fixation and cast immobilization treatment for acute nondisplaced carpal scaphoid fracture.

METHODS:

Relevant domestic and abroad published randomized controlled trials (RCTs) of percutaneous screw insert fixation and cast immobilization treatment for acute nondisplaced carpal scaphoid fracture were searched from Medline, EMBASE, Cochrane library, CNKI and CBM databases by computer.

RESULTS AND CONCLUSION:

Four randomized controlled trials (RCTs) involved 175 patients. The results of Meta-analysis showed that the fracture healing time (SMD=-8.83, 95%CI -10.45 to -7.21, P < 0.000 01) and off work time (MD=-6.86, 95%CI -7.17 to -6.56, P < 0.000 01) in the percutaneous screw insert fixation group were shorter than those in cast immobilization group; the wrist motion (SMD=1.79, 95%CI 1.23 to 2.36, P < 0.000 01) and grip strength (MD=3.53, 95%CI 2.52 to 4.54, P < 0.000 01) were better in the percutaneous screw insert fixation group; the differences of complications had no statistical significance (RR=0.50, 95%CI 0.22 to 1.14, P=0.10). It indicates that percutaneous screw insert fixation treatment for acute nondisplaced carpal scaphoid fracture is superior to cast immobilization treatment. Due to the small sample and limitation of quality in this review, the effectiveness and safety analysis are still needs more high quality and large scale samples of RCTs to get further confirmation.

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