Open Access, Peer-reviewed
pISSN 1226-2102
eISSN 2005-8918
    J Korean Orthop Assoc. 2009 Dec;44(6):668-674. Korean.
    Published online Dec 21, 2009.
    https://doi.org/10.4055/jkoa.2009.44.6.668
    Copyright © 2009 The Korean Orthopaedic Association
    Original Article

    Nonoperative Treatment for Undisplaced Scaphoid Fracture

    Sang-Uk Lee, M.D., Seok-Whan Song, M.D., Seung-Koo Rhee, M.D., Su-Hwan Kang, M.D. and Yong-Soo Park, M.D.
      • Department of Orthopedic Surgery, St. Mary's Hospital, Catholic University Medical College, Seoul, Korea.
    • Correspondence to Seok-Whan Song, M.D. Department of Orthopedic Surgery, St. Mary's Hospital, The Catholic University of Korea, 62, Yoido-dong, Youngdeungpo-gu, Seoul 150-713, Korea. Tel: +82.2-3779-1192, Fax: +82.2-783-0252, Email: sw.song@catholic.ac.kr
    Received February 19, 2009; Accepted October 09, 2009.

    Abstract

    Purpose

    We wanted to evaluate the results of nonoperative treatment for acute, undisplaced, stable scaphoid fracture.

    Materials and Methods

    We retrospectively reviewed 24 cases of acute undisplaced scaphoid fracture that were treated at our department from May 1998 to January 2008. The immobilization method was a long or short arm cast. Flexion-extension exercise was permitted during the period of the short arm cast, but pronation-supination motion was prohibited. After the removal of the cast, active and passive range of motion exercise was started immediately. The result was assessed by the Maudsley scale.

    Results

    The twenty four cases were undisplaced or minimally displaced fracture (10 cases of Herbert type A1, 3 cases of A2 and 11 cases of B2) according to the Mayo classification. The average duration of immobilization was 7.16 weeks. According to the Maudsley scale, 19 cases had an excellent result and 4 cases had a good result. One case had a complication of scapho-lunate dissociation.

    Conclusion

    We recommend conservative treatment with cast immobilization as the first treatment of choice for acute undisplaced scaphoid fracture.

    Keywords
    Scaphoid; Undisplaced fracture; Conservative treatment

    Figures

    Fig. 1
    (A, B) Plain radiographs of 22-year-old female patient showed fracture at the waist of scaphoid. (C, D) After thumb-spica cast for 6 weeks, plain radiographs showed bony union.

    Fig. 2
    (A, B) Plain radiograph and computed tomogram showed scaphoid fracture, Herbert type B2. (C, D) After thumb-spica cast for 7 weeks, the follow-up plain X-ray film showed bony union of the undisplaced fracture fragment.

    Tables

    Table 1
    Clinical Data of Patients

    Table 2
    Method of Assessment and Treatment Result (by Maudsley)

    Table 3
    Results of Treatment by the Maudsley Method

    References

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    MeSH Terms
    Arm
    Dissociative Disorders
    Immobilization
    Range of Motion, Articular
    Retrospective Studies
    Metrics
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    Tables
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