The Prevalence of Anatomical Variations of the Median Nerve in the Carpal Tunnel: A Systematic Review and Meta-Analysis

Henry, Brandon Michael; Zwinczewska, Helena; Roy, Joyeeta; Vikse, Jens; Ramakrishnan, Piravin Kumar; Walocha, Jerzy; Tomaszewski, Krzysztof A.

doi:10.1371/journal.pone.0136477

Cited by 100 publications

(129 citation statements)

References 35 publications

(167 reference statements)

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“…Statistical analysis was performed by BMH, JV, and JR using MetaXL version 2.0 by EpiGear International Pty Ltd (Wilston, Queensland, Australia) to calculate multi-categorical pooled prevalence estimates for the various origins of the MCFA (Henry et al, 2015). The morphometric data was pooled into an analysis using Comprehensive Meta-Analysis version 3.0 by Biostat (Englewood, New Jersey, USA).…”

Section: Methodsmentioning

confidence: 99%

The origin of the medial circumflex femoral artery: a meta-analysis and proposal of a new classification system

Tomaszewski

Henry

Vikse

et al. 2016

PeerJ

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Background and Objectives. The medial circumflex femoral artery (MCFA) is a common branch of the deep femoral artery (DFA) responsible for supplying the femoral head and the greater trochanteric fossa. The prevalence rates of MCFA origin, its branching patterns and its distance to the mid-inguinal point (MIP) vary significantly throughout the literature. The aim of this study was to determine the true prevalence of these characteristics and to study their associated anatomical and clinical relevance.Methods. A search of the major electronic databases Pubmed, EMBASE, Scopus, ScienceDirect, Web of Science, SciELO, BIOSIS, and CNKI was performed to identify all articles reporting data on the origin of the MCFA, its branching patterns and its distance to the MIP. No data or language restriction was set. Additionally, an extensive search of the references of all relevant articles was performed. All data on origin, branching and distance to MIP was extracted and pooled into a meta-analysis using MetaXL v2.0.Results. A total of 38 (36 cadaveric and 2 imaging) studies (n = 4,351 lower limbs) were included into the meta-analysis. The pooled prevalence of the MCFA originating from the DFA was 64.6% (95% CI [58.0–71.5]), while the pooled prevalence of the MCFA originating from the CFA was 32.2% (95% CI [25.9–39.1]). The CFA-derived MCFA was found to originate as a single branch in 81.1% (95% CI [70.1–91.7]) of cases with a mean pooled distance of 50.14 mm (95% CI [42.50–57.78]) from the MIP.Conclusion. The MCFA’s variability must be taken into account by surgeons, especially during orthopedic interventions in the region of the hip to prevent iatrogenic injury to the circulation of the femoral head. Based on our analysis, we present a new proposed classification system for origin of the MCFA.

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Section: Methodsmentioning

confidence: 99%

The origin of the medial circumflex femoral artery: a meta-analysis and proposal of a new classification system

Tomaszewski

Henry

Vikse

et al. 2016

PeerJ

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“…Items for the AQUA Tool were generated on the basis of (1) the extensive background of the steering committee in conceiving and executing anatomical metaanalyses and systematic reviews, and (2) a review of the anatomical literature (Andall et al, 2015;Henry et al, 2015aHenry et al, , 2015bRamakrishnan et al, 2015;Roy et al, 2015;Tomaszewski et al, 2016aTomaszewski et al, , 2016bTomaszewski et al, , 2016cTomaszewski et al, , 2016dVikse et al, 2016). No comprehensive systematic review of systematic reviews was performed because there was no previously-used quality assessment of anatomical studies, and the number of true evidence-based reviews and meta-analyses in the literature is limited.…”

Section: Preliminary Conceptual Design and Item Generationmentioning

confidence: 99%

Development of the Anatomical Quality Assessment (AQUA) Tool for the quality assessment of anatomical studies included in meta‐analyses and systematic reviews

Henry¹,

Tomaszewski²,

et al. 2016

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Critical appraisal of anatomical studies is essential before the evidence from them undergoes meta-epidemiological synthesis. However, no instrument for appraising anatomical studies with inherent applicability to different study designs is available. We aim to develop a generic yet comprehensive tool for assessing the quality of anatomical studies using a formal consensus method. The study steering committee formulated an initial conceptual design and generated items for a preliminary tool on the basis of a literature review and expert opinion. A Delphi procedure was then adopted to assess the validity of the preliminary tool. Feedback from the Delphi panelists was used to improve it. The Delphi procedure involved 12 experts in anatomical research. It comprised two rounds, after which unanimous consensus was reached about the items to be included. The preliminary tool consisted of 20 items, which were phrased as signaling questions and organized into five domains: 1. Aim and subject characteristics, 2. Study design, 3. Characterization of methods, 4. Descriptive anatomy, and 5. Results reporting. Each domain was set to end with a risk of bias question. Following round 1, some of the items underwent major revision, although agreement was reached regarding inclusion of all the domains and signaling questions in the preliminary tool. The tool was revised only for minor language inaccuracies after round 2. The AQUA Tool was designed to assess the quality and reliability of anatomical studies. It is currently undergoing a validation process. Clin. Anat. 30:6-13,

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“…), and the extensive background of the steering committee in conducting meta-analyses and systematic reviews of anatomical studies (Andall et al, 2015;Henry et al, 2015aHenry et al, , 2015bRamakrishnan et al, 2015;Roy et al, 2015aRoy et al, , 2015bTomaszewski et al, 2016aTomaszewski et al, , 2016bTomaszewski et al, , 2016cTomaszewski et al, , 2016dVikse et al, 2016), we developed a preliminary conceptual design for the AQUA Checklist. In addition to items considered standard in reporting all medical studies (sample size, demographics, results, etc.…”

Section: Preliminary Conceptual Design and Item Generationmentioning

confidence: 99%

“…In that context, the authors of the present study have developed the Anatomical Quality Assurance (AQUA) Checklist, the aim of which is to improve the quality of reporting of anatomical studies. From our extensive experience of evidence-based anatomical studies (Andall et al, 2015;Henry et al, 2015aHenry et al, , 2015bRamakrishnan et al, 2015;Roy et al, 2015aRoy et al, , 2015bTomaszewski et al, 2016aTomaszewski et al, , 2016bTomaszewski et al, , 2016cTomaszewski et al, , 2016dVikse et al, 2016), we have found that such studies are often poorly reported, thus decreasing their reliability and increasing the risk of bias. A high reporting quality is imperative since understanding and knowledge of anatomy allows for successful clinical interventions.…”

Section: Introductionmentioning

confidence: 99%

Development of the Anatomical Quality Assurance (AQUA) Checklist: Guidelines for reporting original anatomical studies

Tomaszewski¹,

Henry²,

Ramakrishnan³

et al. 2016

Clinical Anatomy

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The rise of evidence-based anatomy has emphasized the need for original anatomical studies with high clarity, transparency, and comprehensiveness in reporting. Currently, inconsistencies in the quality and reporting of such studies have placed limits on accurate reliability and impact assessment. Our aim was to develop a checklist of reporting items that should be addressed by authors of original anatomical studies. The study steering committee formulated a preliminary conceptual design and began to generate items on the basis of a literature review and expert opinion. This led to the development of a preliminary checklist. The validity of this checklist was assessed by a Delphi procedure, and feedback from the Delphi panelists, who were experts in the area of anatomical research, was used to improve it. The Delphi procedure involved 12 experts in anatomical research. It comprised two rounds, after which unanimous consensus was reached regarding the items to be included in the checklist. The steering committee agreed to name the checklist AQUA. The preliminary AQUA Checklist consisted of 26 items divided into eight sections. Following round 1, some of the items underwent major revision and three new ones were introduced. The checklist was revised only for minor language inaccuracies after round 2. The final version of the AQUA Checklist consisted of the initial eight sections with a total of 29 items. The steering committee hopes the AQUA Checklist will improve the quality and reporting of anatomical studies. Clin.

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The Prevalence of Anatomical Variations of the Median Nerve in the Carpal Tunnel: A Systematic Review and Meta-Analysis

Cited by 100 publications

References 35 publications

The origin of the medial circumflex femoral artery: a meta-analysis and proposal of a new classification system

The origin of the medial circumflex femoral artery: a meta-analysis and proposal of a new classification system

Development of the Anatomical Quality Assessment (AQUA) Tool for the quality assessment of anatomical studies included in meta‐analyses and systematic reviews

Development of the Anatomical Quality Assurance (AQUA) Checklist: Guidelines for reporting original anatomical studies

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