Daher M, Roukoz S, Chalhoub R, Ghoul A, Tarchichi J, Aoun M, Sebaaly A. Management of Displaced Metacarpal Shaft Fractures: A Systematic Review and Meta-analysis.
JPRAS Open 2023;
38:163-172. [PMID:
37920285 PMCID:
PMC10618610 DOI:
10.1016/j.jpra.2023.10.002]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/01/2023] [Indexed: 11/04/2023] Open
Abstract
Background
Affecting mainly the working population, metacarpal shaft fractures account for up to 31% of hand fractures. To manage this entity, conservative management can be equal to operative management. However, surgeons tend to favor operative management in order to reduce the rate of complications, such as shortening and malunion. This meta-analysis was conducted to compare conservative to operative management of displaced metacarpal shaft fractures.
Methods
PubMed, Cochrane, and Google Scholar (pages 1-20) were searched until August 2023. The clinical outcomes consisted of postoperative shortening, Disabilities of Arm, Shoulder, and Hand (DASH) score, and mean grip strength.
Results
Only three studies were included in this meta-analysis. Operative management was shown to reduce postoperative shortening (p<0.00001). However, conservative management had a better postoperative DASH score (p=0.001).
Conclusion
Better DASH scores were seen in the conservative group, but there was a higher postoperative shortening. However, studies have shown that the shortening has no effect on the functional outcome. Nevertheless, more randomized controlled studies and cost-effectiveness studies are needed to confirm these findings.
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