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Abstract：
Background: Several operative treatments exist for scaphoid fractures, varying by approach (e.g., ercutaneous, volar, or dorsal), implant type (e.g., screw or Kirschner wire), and bone raft choice (e.g., none, nonvascularized, or vascularized). Many previous systematic eviews and meta-analyses have investigated outcomes following different surgicalÚpproaches, the use of vascularized versus nonvascularized bone graft for scaphoidßracture nonunions, and treatment for specific fracture patterns. However, given the advancements n scaphoid fracture treatment in recent years, there is a need for updated treatment recommendations hat would be beneficial to hand surgeons. Purpose: We present a comprehensive review of the operative treatment of scaphoid fractures based on recent literature and propose a unified treatment algorithm for managing these fractures. Methods: The English-language literature was searched from 2002 to 2023 for high evidence level (e.g., randomized trials), review, and meta-analysis articles with the following search terms: \"scaphoid, \"u8220\"scaphoid\" AND \"nonunion, \" and \"scaphoid\" AND \"malunion. \" Each article was creened by the authors to determine the scaphoid fracture scenario addressed and ubsequent treatment recommendations. The findings from article reviews were then rganized by scaphoid fracture types in this manuscript. Results: A total of 95 pertinent articles were ultimately selected and used as the basis for reviewing different scaphoid fracture scenarios. A treatment algorithm was then proposed based on literature review. Conclusion: This summary of the recent literature can guide hand surgeons in addressing scaphoidßractures. Future research in scaphoid fracture treatment, particularly for nonunions, would be most beneficial n the form of systematic review, meta-analysis, or multicenter prospective randomized clinical trials. Level of Evidence: IV.
摘要：
背景：目前存在几种治疗舟骨骨折的手术方法，因方法而异(例如，皮肤，volar,或背侧)，植入物类型(例如，螺钉或克氏针)，和骨筏选择(例如，无,非血管化，或血管化)。许多以前的系统评价和荟萃分析已经调查了不同手术后的结果，使用血管化和非血管化骨移植物治疗肩胛骨不愈合，和治疗特定的断裂模式。然而,鉴于近年来舟骨骨折治疗的进展，有必要更新的治疗建议帽子将有利于手外科医师。目的：我们根据最近的文献对舟骨骨折的手术治疗进行了全面的综述，并提出了一种统一的治疗方法来管理这些骨折。方法：从2002年至2023年搜索英语文献以获得较高的证据水平(例如，随机试验)，review,和具有以下搜索词的荟萃分析文章：“舟骨，\"u8220\"舟骨\"和\"骨不连，\"和\"舟骨\"和\"malunion。“每篇文章都是由作者创造的，以确定舟骨骨折的情况和随后的治疗建议。文章评论的结果随后被这篇手稿中的舟骨骨折类型所描述。结果：最终选择了95篇相关文章，并将其用作回顾不同舟骨骨折情况的基础。然后在文献综述的基础上提出了一种治疗算法。结论：对最新文献的总结可以指导手外科医师解决舟骨。舟骨骨折治疗的未来研究，特别是对于不结合，在系统审查的形式中，将是最有益的，荟萃分析，或多中心前瞻性随机临床试验。证据等级：IV。
