最好的证据系统审查和微型开放的手腕道释放的元分析
Warren C Hammert1, Kevin C Chung2, Larry E Miller3
1Department of Orthopaedic Surgery, Division of Hand Surgery, Duke University Medical Center, Durham, NC.
Journal of hand surgery global online
|February 5, 2024
概括
迷你开放的手腕道释放 (mOCTR) 显著改善了手臂功能并减少了疼痛. 这种有效的手术选择具有较低的并发症率,结果受到患者症状和切口长度的影响.
科学领域:
- 整形外科手术 整形外科手术
- 基于证据的医学基于证据的医学.
背景情况:
- 手腕道综合征 (CTS) 是一种常见的疾病,导致手部麻木和疼痛.
- 迷你开放的手掌道释放 (mOCTR) 是一种手术技术来缓解CTS.
- 评估mOCTR的安全性和有效性对于临床实践至关重要.
研究的目的:
- 系统地评估迷你开放式手腕道释放 (mOCTR) 的安全性和有效性.
- 综合来自对mOCTR结果的当代前性研究的最佳证据.
主要方法:
- 针对具有≥50个mOCTR病例的前性研究 (2013年1月 - 2023年7月) 的系统文献搜索.
- 结果的元分析,包括手臂,肩膀和手的快速残疾问卷 (QDASH),波士顿手腕道问卷 (BCTQ) 尺度,疼痛,并发症率和重新手术率的视觉模拟尺度 (VAS).
- 进行元回归分析,以确定影响手术结果的因素.
主要成果:
- 包括23项与2,303名患者的研究;中位数随访6-12个月.
- mOCTR显示在QDASH,BCTQ症状严重程度尺度 (BCTQ-SSS),BCTQ功能状态尺度 (BCTQ-FSS) 和疼痛VAS (所有P<.001) 中显著改善.
- 并发症率为8.9%,主要是暂时的支柱疼痛或痕问题,随着切口的长度增加而增加. 修订率为0.6%. 修订率为0.6%.
结论:
- mOCTR是一种有效的手术治疗手腕道综合征,显著改善功能和疼痛.
- 结果受到患者的 baseline 症状和手术切口长度的影响.
- 建议进行较短的切口,以尽量减少并发症,同时确保横带的安全释放.
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