A Meta-Analysis of Operative Versus Nonoperative Treatment In 463 Scapular Neck Fractures

作者：Thomas Dienstknecht, Klemens Horst, Miguel Pishnamaz, Richard Martin Sellei, Philipp Kobbe, Arne Berner · 发表于：Scandinavian Journal of Surgery · 年份：2013 · DOI：10.1177/1457496913482251 · 被引用次数：28 · 研究领域：Shoulder and Clavicle Injuries、Shoulder Injury and Treatment、Orthopedic Surgery and Rehabilitation

BACKGROUND AND AIMS: Treatment of scapular neck fractures remains controversial. Advantages of surgical treatments, such as anatomical restoration of fracture displacement, are counterbalanced by approach morbidity. We conducted a meta-analysis of 463 scapular neck fractures and compared clinical, functional, and radiographical outcomes in operatively and nonoperatively treated scapular neck fractures. MATERIAL AND METHODS: A literature search was conducted, including the databases PubMed/MEDLINE, Embase, and the Cochrane Database of Systematic Reviews. Manuscripts were included if they reported a precise description of treatment, complications, functional outcomes, and/or radiographic evaluation. Data about day-to-day activities, level of pain-freeness, range of motion, functional grading, and radiographical assessment were pooled and compared using fixed effects models. RESULTS AND CONCLUSIONS: A total of 22 manuscripts were relevant, including 1 prospective cohort study and 21 retrospective studies. The studies showed a high heterogeneity in the result assessment. Most patients had concomitant injuries. In total, 234 out of the 463 fractures were treated operatively. Pain-freeness and radiographic outcome measurements were significantly better in the operatively treated group, whereas range of motion was significantly improved in the nonoperative treated patients. Complication rate for surgical treatment was about 10%. From the achievable data, there was no bias detected w...