The Hand Patient: Fracture of the scaphoid

Abstract

Much confusion exists as to the type of splinting that should be used for scaphoid fractures. It has been shown that a well fitted tight circular POP with the thumb included in abduction and the wrist in 30 degrees of dorsiflexion is adequate for undisplaced scaphoid fractures. It is recommended that any unstable scaphoid fracture i.e. any amount of displacement seen on radial or ulnar deviated x-ray view should be operated on. Anatomical reduction and internal fixation with one of the compression screws available is the method at choice. The postoperative immobilization should not be longer than six to twelve weeks at the most. The reason for this is that long-term immobilization causes osteopenia which is a further contributing factor for delayed union.