Chinese Journal of Tissue Engineering Research ›› 2012, Vol. 16 ›› Issue (13): 2384-2388.doi: 10.3969/j.issn.1673-8225.2012.13.025

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Percutaneous screw insert fixation versus cast immobilization treatment for acute nondisplaced carpal scaphoid fracture: A systematic review   

Liu Wei1, Zhao Jin-min1, Su Wei1, Tang Shi-ting2, Xiong Kai1   

  1. 1Department of Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning  530021, Guangxi Zhuang Autonomous Region, China; 2Department of Neurology, Guangxi Zhuang Autonomous Region People’s Hospital, Nanning  530021, Guangxi Zhuang Autonomous Region, China
  • Received:2011-09-20 Revised:2011-10-03 Online:2012-03-25 Published:2012-03-25
  • Contact: author: Zhao Jin-min, Professor, Doctoral supervisor, Department of Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China zhaojinmin@126.com
  • About author:Liu Wei★, Studying for master’s degree, Department of Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China jxgxliuwei@163.com

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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 confirm

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