Abstract
Traditionally scaphoid waist fractures have been treated with a long period, 10–12 weeks, of immobilization in a plaster cast until radiological union. The long period of immobilization sometimes infers great discomfort for the patients. To avoid this, surgical treatment with screw fixation has for the last decade been advocated as an option also for undisplaced fractures. In this report, we present five cases with undisplaced scaphoid waist fractures that have healed both radiologically and clinically without any immobilization at all or after a very short period of protection in a cast. These observations challenge the current treatment guidelines.
Highlights
Scaphoid waist fractures without significant displacement are usually treated non-operatively by immobilization in a cast
Time to radiographic union may vary, and more recently, shorter immobilization for approximately 6 weeks has been found sufficient for undisplaced fractures, and using this management union has been reported in approximately 90% [3]
There may be several patient-related factors such as age, smoking, and fracture-specific factors for instance vascularity of the fracture fragments, instability of the fracture and fracture pattern that can have an impact on healing potential. This means that the time to union and the tendency for healing disturbances may vary depending on inherent fracture characteristics
Summary
Scaphoid waist fractures without significant displacement are usually treated non-operatively by immobilization in a cast. The following report describes five patients in whom union of an undisplaced scaphoid waist fracture took place without or after a very short time of immobilization. A 24-year-old, professional, ice hockey player sustained a dorsiflexion trauma to his non-dominant left wrist during a game when he was checked into the board.
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