Union and Complication Rates After Total Wrist Arthrodesis: A Systematic Review and Meta-Analysis

IF 2.1 2区医学 Q2 ORTHOPEDICS

Journal of Hand Surgery-American Volume Pub Date : 2025-04-01 DOI:10.1016/j.jhsa.2023.10.011

David H. Owen MBBS , Joshua W. Booth BSc, MD , Paul A. Agius BA, MSc , Diana M. Perriman BSc(Physio), PhD , Paul N. Smith MBBS , Chris J. Roberts MBBS

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引用次数: 0

Abstract

Purpose

Total wrist arthrodesis (TWA) has been performed using various techniques. We aimed to provide pooled prevalence estimates of union and complications of TWA by technique. A secondary aim was to provide estimates of union and complication rates by treatment of the carpometacarpal joint (CMCJ) in TWA using plates. Given the widespread adoption of wrist arthrodesis plates (WAP), we hypothesized that these implants would result in higher union and lower complication rates. We also hypothesized that TWA with CMCJ arthrodesis would improve these outcomes.

Methods

Online databases including PubMed, Medline, Embase, and Cochrane were searched. Studies reporting union and/or complication rates of 10 or more TWA performed with a similar technique (analyzed as bone graft only, bone graft with minimal fixation, intramedullary, augmented intramedullary, plate, WAP, and other) were included. Studies with fewer than 10 TWA, studies reporting TWA where union or complications could not be analyzed separately, and studies without union and complication rates were excluded. Data extraction was performed independently by two English-speaking reviewers with a translator where required. Pooled prevalence estimates were made using a random-effects meta-analysis model and presented as a percent prevalence with 95% confidence and prediction intervals.

Results

One hundred and thirty-six studies with a total of 3,517 patients and 3,969 TWA were analyzed. No differences in union and complication prevalence were observed between TWA techniques and in TWA with different treatments of the CMCJ using plates and WAP.

Conclusion

Using meta-analysis, we found no difference in union and complication prevalence between TWA techniques and TWA with different treatments of the CMCJ with plates and WAP. It must be acknowledged that this research included low-quality studies with high heterogeneity, and confidence in the precision of the estimates is low.

Type of study/level of evidence

Prognostic IV.

查看原文本刊更多论文

全腕关节置换术后的愈合和并发症发生率:系统回顾和荟萃分析。

目的:全腕关节融合术(TWA)采用多种技术进行。我们的目的是通过技术提供TWA愈合和并发症的综合患病率估计。第二个目的是估计使用钢板治疗TWA腕掌关节(CMCJ)的愈合和并发症发生率。鉴于腕部关节融合术钢板(WAP)的广泛应用，我们假设这些植入物会导致更高的愈合和更低的并发症发生率。我们还假设TWA联合CMCJ关节融合术可以改善这些结果。方法:检索PubMed、Medline、Embase、Cochrane等在线数据库。研究报告了采用类似技术进行的10例或以上TWA的愈合和/或并发症发生率(仅分析骨移植物、骨移植物最小固定、髓内、增强髓内、钢板、WAP等)。不包括少于10个TWA的研究，报告TWA合并或并发症无法单独分析的研究，以及没有合并和并发症发生率的研究。数据提取由两名说英语的审稿人独立完成，必要时配有翻译。使用随机效应荟萃分析模型进行合并患病率估计，并以95%置信度和预测区间的百分比患病率表示。结果:136项研究共分析了3,517例患者和3,969例TWA。TWA技术与采用钢板和WAP治疗不同CMCJ的TWA在愈合和并发症发生率方面无差异。结论:通过meta分析，我们发现TWA技术与TWA在不同钢板和WAP治疗CMCJ的愈合和并发症发生率方面没有差异。必须承认，本研究包括高异质性的低质量研究，对估计精度的信心很低。研究类型/证据水平:预后IV。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hand Surgery-American Volume 医学-外科

CiteScore

3.20

自引率

10.50%

发文量

402

审稿时长

12 weeks

期刊介绍： The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.