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J Hand Surg Eur Vol · Oct 2009
Undisplaced scaphoid waist fractures: is 4 weeks' immobilisation in a below-elbow cast sufficient if a week 4 CT scan suggests fracture union?
- J M Geoghegan, M J Woodruff, R Bhatia, J S Dawson, R W Kerslake, N D Downing, J A Oni, and T R C Davis.
- Departments of Trauma and Orthopaedics and Radiology, Queen's Medical Campus, Nottingham University Hospitals NHS Trust, Nottingham, UK.
- J Hand Surg Eur Vol. 2009 Oct 1; 34 (5): 631-7.
AbstractThis prospective study investigated a cohort of 59 scaphoid waist fractures which were treated nonoperatively in a below-elbow plaster cast for 4 weeks and then underwent a Week 4 CT scan to assess displacement and progress to union. Forty-three were classed as undisplaced and 37 of these 43 were also classed as 'united'. All the 37 undisplaced and 'united' fractures united with up to 8 weeks' cast immobilisation, including 26 which were taken out of plaster at 4 weeks and mobilised. We conclude that scaphoid waist fractures which appear to be undisplaced and united on a week 4 CT scan will unite, and may not need to be immobilised in a plaster cast for more than 4 weeks. Such a treatment policy may reduce the period of disability and time off work associated with nonoperative treatment.
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