J Korean Orthop Assoc.  2009 Dec;44(6):668-674. 10.4055/jkoa.2009.44.6.668.

Nonoperative Treatment for Undisplaced Scaphoid Fracture

• Lee SU
• Song SW
• Rhee SK
• Kang SH
• Park YS

• KMID: 2186294
• DOI: http://doi.org/10.4055/jkoa.2009.44.6.668

Abstract

PURPOSE
We wanted to evaluate the results of nonoperative treatment for acute, undisplaced, stable scaphoid fracture.
MATERIALS AND METHODS
We retrospectively reviewed 24 cases of acute undisplaced scaphoid fracture that were treated at our department from May 1998 to January 2008. The immobilization method was a long or short arm cast. Flexion-extension exercise was permitted during the period of the short arm cast, but pronation-supination motion was prohibited. After the removal of the cast, active and passive range of motion exercise was started immediately. The result was assessed by the Maudsley scale.
RESULTS
The twenty four cases were undisplaced or minimally displaced fracture (10 cases of Herbert type A1, 3 cases of A2 and 11 cases of B2) according to the Mayo classification. The average duration of immobilization was 7.16 weeks. According to the Maudsley scale, 19 cases had an excellent result and 4 cases had a good result. One case had a complication of scapho-lunate dissociation.
CONCLUSION
We recommend conservative treatment with cast immobilization as the first treatment of choice for acute undisplaced scaphoid fracture.

Keyword

Scaphoid; Undisplaced fracture; Conservative treatment

MeSH Terms

Arm
Dissociative Disorders
Immobilization
Range of Motion, Articular
Retrospective Studies

Figure

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  Fig. 1 (A, B) Plain radiographs of 22-year-old female patient showed fracture at the waist of scaphoid. (C, D) After thumb-spica cast for 6 weeks, plain radiographs showed bony union.

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  Fig. 2 (A, B) Plain radiograph and computed tomogram showed scaphoid fracture, Herbert type B2. (C, D) After thumb-spica cast for 7 weeks, the follow-up plain X-ray film showed bony union of the undisplaced fracture fragment.

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