Prospective randomized study - fixation vs non fixation of acute scaphoid fractures

Abstract

Aim: To compare the results of operative fixation of acute scaphoid fractures with those of non-operative treatment. Materials & Method: This clinical study was carried out among 26 patients with an acute nondisplaced or minimally displaced scaphoid fracture reported to the OPD of Department of Orthopedics, Shri Krishna Medical College and Hospital Muzaffarpur, Bihar, India. Patients were randomly allocated to group A (non-operative treatment with a cast) and group B (internal fixation with a Herbert screw).  Results: Mean age of the study population was 41.23 years. Majority of them were male 21 (80.7%) and rest 5 (19.3%) were female. Out of total 26 scaphoid fracture cases 16 (61.5%) were of right hand and rest 10 (38.5%) found on the left hand. Most common location of fracture was waist fracture (B2) 10 cases. 100% union was observed in group B. Conclusions: Study proves that cast treatment has the disadvantages of longer immobilisation time, joint stiffness, reduced grip strength, and longer time to return to work whereas the operative fixation of acute scaphoid fractures results in predictable satisfactory union rate and good functional outcome.

Keywords: ​cast treatment, scaphoid fracture