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Randomised controlled trials in hand surgery: a scoping review
Juuso Heikkinen1, Soumen Das De2, Jarkko Jokihaara3
1Orthopedic and Traumatology, Oulu University Hospital, Oulu, Finland juuso.heikkinen@fimnet.fi.
Objectives:
To identify the evidence gaps that exist regarding the efficacy or effectiveness of hand surgery.
Setting:
A scoping review. We systematically searched MEDLINE, Embase and CENTRAL databases to identify all hand surgical randomised controlled trials from inception to 7 November 2020.
Results:
Of the 220 identified randomised controlled trials, none were fundamental efficacy trials, that is, compared surgery with placebo surgery. 172 (78%) trials compared the outcomes of different surgical techniques, and 143 (65%) trials were trauma related. We identified only 47 (21%) trials comparing surgery with non-operative care or injection.
Conclusion:
The evidence supporting use of surgery especially for chronic hand conditions is scarce. To determine optimal care for people with hand conditions, more resources should be aimed at placebo-controlled trials and pragmatic effectiveness trials comparing hand surgery with non-operative care.
Prospero Registration Number:
CRD42019122710.
