Randomised controlled trials in hand surgery: a scoping review

Juuso Heikkinen, Soumen Das De, Jarkko Jokihaara, Kati Jaatinen, Rachelle Buchbinder, Teemu Karjalainen

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Abstract

OBJECTIVES: To identify the evidence gaps that exist regarding the efficacy or effectiveness of hand surgery. SETTING: A scoping review. We systematically searched MEDLINE, Embase and CENTRAL databases to identify all hand surgical randomised controlled trials from inception to 7 November 2020. RESULTS: Of the 220 identified randomised controlled trials, none were fundamental efficacy trials, that is, compared surgery with placebo surgery. 172 (78%) trials compared the outcomes of different surgical techniques, and 143 (65%) trials were trauma related. We identified only 47 (21%) trials comparing surgery with non-operative care or injection. CONCLUSION: The evidence supporting use of surgery especially for chronic hand conditions is scarce. To determine optimal care for people with hand conditions, more resources should be aimed at placebo-controlled trials and pragmatic effectiveness trials comparing hand surgery with non-operative care. PROSPERO REGISTRATION NUMBER: CRD42019122710.

Original languageEnglish
Article numbere062773
Number of pages5
JournalBMJ Open
Volume12
Issue number10
DOIs
Publication statusPublished - 10 Oct 2022

Keywords

  • hand & wrist
  • plastic & reconstructive surgery
  • surgery

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