University of Oulu

Heikkinen J, Das De S, Jokihaara J, et alRandomised controlled trials in hand surgery: a scoping reviewBMJ Open 2022;12:e062773. doi: 10.1136/bmjopen-2022-062773

Randomised controlled trials in hand surgery : a scoping review

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Author: Heikkinen, Juuso1; Das De, Soumen2; Jokihaara, Jarkko3;
Organizations: 1Orthopedic and Traumatology, Oulu University Hospital, Oulu, Finland
2Department of Hand & Reconstructive Microsurgery, National University Hospital, Singapore
3Department of Hand Surgery, Faculty of Medicine and Life Sciences, Tampere University Hospital, Tampere, Finland
4University of Jyväskylä, University of Jyväskylä, Jyvaskylä, Finland
5Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
6Unit of Hand Surgery, Department of Surgery, Central Finland Central Hospital, Jyvaskyla, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1 MB)
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Language: English
Published: BMJ, 2022
Publish Date: 2023-06-27


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.

Conclusions: 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.

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Series: BMJ open
ISSN: 2044-6055
ISSN-E: 2044-6055
ISSN-L: 2044-6055
Volume: 12
Issue: 10
Article number: e062773
DOI: 10.1136/bmjopen-2022-062773
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Copyright information: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: