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.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9557326 | PMC |
| http://dx.doi.org/10.1136/bmjopen-2022-062773 | DOI Listing |
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