Effectiveness of surgical interventions for treating de Quervain's disease: A systematic review and meta-analysis

INTRODUCTION: This systematic review of randomized controlled trials was undertaken to assess whether any of the various currently used surgical interventions have better functional outcomes and less impairment or fewer surgical complications compared to the other common surgical interventions in de Quervain's disease. MATERIAL AND METHODS: Relevant studies related to surgical interventions in de Quervain's disease based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines were identified from PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials for randomized controlled trials comparing surgical interventions in de Quervain's disease published from January 2000 to December 2020. Functional outcome and impairment were the primary outcomes assessed. RESULTS: Three trials met the eligibility criteria which were following randomized controlled trial or quasi-experimental trial enrolling adults ≥18 years of age diagnosed with de Quervain's disease, comparing clinical outcomes between different surgical interventions, and including functional outcomes, impairment, pain and complications data. The Cochrane Risk of Bias Assessment Tool and GRADE approach were used to ascertain methodological quality. Statistical heterogeneity was tested with I-square and chi-square tests. The longitudinal skin incision probably slightly reduced superficial radial nerve injury, vein injury, scar hypertrophy, and total complications compared with the transverse skin incision with relative risk: 0.14, very low certainty by GRADE; 0.10, very low certainty by GRADE; 0.57, very low certainty by GRADE; and 0.23, very low certainty by GRADE, respectively. CONCLUSION: Concerning the analysis of functional and pain scores, no significant results were able to be concluded. This study's findings must be considered in the light of quality and sample size limitations, and further high quality prospective randomized controlled clinical trials are needed to draw more firm conclusions.