[Conservative treatment of scaphoid fractures]

Ned Tijdschr Geneeskd. 2019 Mar 21:163:D2978.
[Article in Dutch]

Abstract

Considering that pseudoarthrosis, or non-union, often occurs in patients with scaphoid fractures it is very important to start adequate treatment as soon as possible. On the basis of the literature, we advise immobilisation in a below-elbow cast, whereby the thumb is not immobilised and the wrist is in a slightly extended position. Despite the fact that non-dislocated fractures, at the very least, are usually consolidated within 4 weeks, we advise an immobilisation period of 6 weeks followed by clinical or radiological evaluation. If the fracture fails to consolidate, we advise prolonged immobilisation with two-weekly evaluation. There is no evidence in the literature of a positive effect of pulsed electromagnetic field therapy or pulsed low-intensity ultrasound therapy on healing of scaphoid fractures.

MeSH terms

  • Adult
  • Casts, Surgical*
  • Conservative Treatment / methods*
  • Female
  • Fractures, Bone / therapy*
  • Humans
  • Male
  • Scaphoid Bone / injuries*
  • Wrist Injuries / therapy*