• J Bone Joint Surg Br · Jan 2008

    Randomized Controlled Trial Multicenter Study Comparative Study

    Percutaneous screw fixation versus conservative treatment for fractures of the waist of the scaphoid: a prospective randomised study.

    • M M McQueen, M K Gelbke, A Wakefield, E M Will, and C Gaebler.
    • Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, Old Dalkeith Road, Edinburgh EH16 4SU, UK. mmcqueen@staffmail.ed.ac.uk
    • J Bone Joint Surg Br. 2008 Jan 1; 90 (1): 66-71.

    AbstractWe randomly allocated 60 consecutive patients with fractures of the waist of the scaphoid to percutaneous fixation with a cannulated Acutrak screw or immobilisation in a cast. The range of movement, the grip and pinch strength, the modified Green/O'Brien functional score, return to work and sports, and radiological evidence of union were evaluated at each follow-up visit. Patients were followed sequentially for one year. Those undergoing percutaneous screw fixation showed a quicker time to union (9.2 weeks vs 13.9 weeks, p < 0.001) than those treated with a cast. There was a trend towards a higher rate of nonunion in the non-operative group, although this was not statistically significant. Patients treated by operation had a more rapid return of function and to sport and full work compared with those managed conservatively. There was a very low complication rate. We recommend that all active patients should be offered percutaneous stabilisation for fractures of the waist of the scaphoid.

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