手和前臂部分延伸肌撕裂的管理:系统性审查
Kathryn Dickson1, Angelos Mantelakis2, Alistair J M Reed3
1University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK.
概括
在手和前臂部分延伸肌撕裂的管理显示有限的证据. 对某些部分伤的非手术治疗似乎是安全的,但需要更多的试验.
科学领域:
- 整形外科手术 整形外科手术
- 手术手术手术手术手术
- 创伤学 创伤学 创伤学
背景情况:
- 手和前臂的伸展器机制受伤是常见的,并导致显著的功能障碍.
- 完整的肌撕裂通常需要手术修复.
- 部分肌损伤的治疗方法各不相同,有些人通过 splinting 和物理治疗进行非手术治疗.
研究的目的:
- 系统地审查有关手和前臂部分延伸肌撕裂的最佳管理的现有文献.
- 评估支持手术与非手术治疗这些伤害的证据.
主要方法:
- 在PubMed,EMBASE,clinicaltrials.gov和Cochrane CENTRAL (1990-2022) 进行了系统的文献搜索.
- 在PROSPERO (CRD42021250431) 登记了一份潜在的协议.
- 在查了4565项研究后,五项研究 (1项RCT,4项队列研究) 符合纳入标准.
主要成果:
- 操作性和非操作性组之间,握力和抓力强度以及返回工作时间是可比的.
- 在接受手术修复的患者中发现了不良结果,而在非手术组中没有报告任何不良结果.
- 由于研究异质性和偏差高风险,元分析是不可行的.
结论:
- 只有有限的高质量的证据来指导部分延伸肌撕裂的管理.
- 低质量的证据表明,非手术治疗可能是安全的选择部分撕裂.
- 务实,多中心随机试验对于评估治疗的成本效益至关重要.
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