mdlinx mdlinx
Latest (227) Full Text Articles (3822) Article Summary

Management of displaced fractures of the waist of the scaphoid: Meta-analyses of comparative studies
Injury,  Evidence Based Medicine  Clinical Article

Singh HP et al. – Displaced fractures of scaphoid have a four times higher risk of nonunion than undisplaced fractures when treated in a plaster cast, and the patients should be advised of this risk. Nonunion is more likely if a displaced fracture of the scaphoid is treated in a plaster cast.

Methods
  • Electronic databases were searched using the Medical Subject Headings (MeSH) controlled vocabulary (scaphoid fractures, AND’d with displaced, or nonunion, or non–healing or cast immobilisation, or plaster or surgery).
  • At present, there are no randomised, controlled trials or studies comparing fixation to plaster cast treatment of displaced fractures of the scaphoid.
  • The search was therefore limited to observational studies of displaced fractures of the scaphoid treated in a plaster cast (non–operative group) or fixed surgically (operative group).
  • The criterion for displacement was limited to gap or step of more than mm.
  • In the non–operative group, the authors compared the outcome of displaced and undisplaced fractures of the waist of the scaphoid treated in a plaster cast.
  • In the operative group, contingency table analysis was used to calculate the odds ratio of nonunion with plaster treatment compared to surgery.

Results
  • In the non–operative group, seven studies were included in a meta–analysis with a total of 1401 scaphoids.
  • Ninety–three percent (1311 scaphoids) of these scaphoid fractures healed in a plaster cast.
  • A total of 207 (15%) of all scaphoid fractures showed displacement of at least 1mm (gap/step) between fracture fragments.
  • Nonunion was identified in 18% (37/207) of displaced scaphoid fractures treated in a plaster cast.
  • The pooled relative risk of fracture nonunion was 4.4 (95% confidence interval (CI): 2.3–8.7; p=0.00; I2=54.3%).
  • In the surgical group, they identified six observational studies in which 157 ‘displaced’ fractures of the scaphoid were surgically fixed.
  • Only two of these fractures did not heal. The odds of nonunion were 17 times higher with plaster cast treatment than surgery.

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Nurse Practitioner

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Nurse Practitioner Articles

Last month's top read Top Articles of 2013

1 Evidence-informed frameworks for cost-effective cancer care and prevention in low, middle, and high-income countries The Lancet Oncology, March 10, 2014    Clinical Article

2 Tea consumption and leukemia risk: A meta-analysis Tumor Biology, February 12, 2014    Evidence Based Medicine    Clinical Article

3 Vitamin D and cardiovascular disease Circulation Research, February 3, 2014    Review Article    Clinical Article

4 Vitamin D deficiency in alopecia areata British Journal of Dermatology, March 24, 2014    Clinical Article

5 Coffee intake and gastric cancer risk Cancer Epidemiology, Biomarkers & Prevention, March 19, 2014    Clinical Article

6 Egg consumption and risk of GI neoplasms: dose–response meta-analysis and systematic review European Journal of Nutrition, February 6, 2014    Evidence Based Medicine    Review Article

7 Alternate day fasting for weight loss in normal weight and overweight subjects: A randomized controlled trial Full Text Nutrition Journal, November 27, 2013    Free full text    Clinical Article

8 Meta-analysis of vitamin D sufficiency for improving survival of patients with breast cancer Anticancer Research, March 14, 2014    Evidence Based Medicine    Clinical Article

9 Meat consumption and the risk of hepatocellular carcinoma Alimentary Pharmacology and Therapeutics, March 6, 2014    Review Article

10 Vitamin and mineral supplements in the primary prevention of cardiovascular disease and cancer: An updated systematic evidence review for the U.S. preventive services task force Annals of Internal Medicine, November 13, 2013    Evidence Based Medicine    Clinical Article

11 Aspirin use in heart failure Circulation: Heart Failure, March 19, 2014    Clinical Article

12 Long-term coffee consumption and risk of cardiovascular disease Circulation, February 11, 2014    Evidence Based Medicine    Review Article    Clinical Article

13 Role of walnuts in maintaining brain health with age The Journal of Nutrition, February 21, 2014    Review Article

14 Yogurt consumption and impact on health: focus on children and cardiometabolic risk American Journal of Clinical Nutrition, March 21, 2014    Review Article

15 Dairy intake and semen quality among men attending a fertility clinic Fertility and Sterility, March 20, 2014    Clinical Article

16 Effects of yoga on cardiovascular disease risk factors: A systematic review and meta-analysis International Journal of Cardiology, March 17, 2014    Evidence Based Medicine    Review Article    Clinical Article

17 Tea consumption and the risk of five major cancers: A dose-response meta-analysis of prospective studies Full Text BMC Cancer, March 18, 2014    Free full text    Evidence Based Medicine    Review Article

18 Is ginger effective for the treatment of irritable bowel syndrome? A double blind randomized controlled pilot trial Complementary Therapies in Medicine, March 4, 2014    Clinical Article

19 Egg consumption and cardiovascular disease among diabetic individuals: A systematic review of the literature Full Text Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, March 28, 2014    Free full text    Review Article

20 Tracheoplasty using the thymus against tracheo-esophageal fistula due to necrotizing tracheobronchitis in a very low birth weight infant Pediatric Pulmonology, March 12, 2014

Indexed Journals in Nurse Practitioner: Journal of the American Academy of Nurse Practitioners, Holistic Nursing Practicemore

Other Topics in Nurse Practitioner

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Stay current - Media Tool

Newsletter
RSS
Follow
Like

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close