Nonoperative compared with operative treatment of acute scaphoid fractures. A randomized clinical trial.

Background: Traditionally, acute nondisplaced scaphoid fractures have been treated nonoperatively in a cast, and the expected union rate approaches 90%. Internal fixation of nondisplaced scaphoid fractures has increased in popularity, and a union rate of 100% has been reported. The growing trend is to recommend internal fixation for the majority of acute scaphoid fractures.

Comparison of direct and indirect costs of internal fixation and cast treatment in acute scaphoid fractures: a randomized trial involving 52 patients.

Background: The most cost-effective treatment of scaphoid fractures has not yet been determined.

Methods: In a prospective trial, 52 employed or selfemployed patients with scaphoid fractures were randomized to closed (cast) or surgical treatment.

Results: There were 3 complications in the surgical group and 1 in the cast group.

Patient-rating of long term results of silicone implant arthroplasty of the scaphoid.

Thirty-two patients had silicone implant arthroplasty of the scaphoid in our unit between 1974-1988. Ten years later eight had had their implants removed because they had failed. Twenty-four of the 32 were reviewed at an intermediate clinical follow up examination between 1988-89 and 21 by patient rated wrist evaluation 10 years later.