Scaphoid fractures Dorsal versus volar approach for screw fixation

Abstract

It is not clear whether the dorsal or volar approach is superior for screw fixation of scaphoid fractures, based on limited evidence from three small retrospective cohort studies with a total of 87 patients. Fracture union rates, functional outcomes, pain, and complications appear to be similar in patients treated with dorsal and volar approaches. Statistical significance was not consistent across studies, which may be a function of sample size and/or bias in some studies. To better understand the differences in outcomes between dorsal and volar approaches to screw fixation of scaphoid fractures, additional larger, methodologically rigorous trials are needed. A multi-center study may provide sufficient power to effectively study this question. 根据3项小样本回顾性队列研究(共计87例患者)所获得的证据,在舟状骨骨折治疗时,目前仍不能确定背侧入路与掌侧入路螺钉固定何者更优.虽然骨折愈合率、功能状况、疼痛、并发症的发生率在两种方法间相似,但是各研究所得的统计学差异并不一致,这可能是由于研究的样本量较小或者研究中存在偏倚导致的.为了更好地比较背侧与掌侧入路螺钉固定治疗舟状骨骨折的疗效,应开展具有大样本的、严格方法学的临床试验研究.采用多中心研究更有利于该问题的回答.……