Functional outcome in conservatively treated non-displaced scaphoid fractures


Purpose: This study evaluated the functional outcome after conservative treatment of non-displaced scaphoid fractures using an international validated outcome scale (DASH). Methods and materials: Between 2005 and 2010, 60 patients with a non-displaced scaphoid fracture were included. When a patient visited the emergency department and was clinically suspected of a scaphoid fracture radiography was performed. If no fracture was diagnosed with this modality a CT or MRI-scan both in combination with bonescintigraphy was performed. Patients with scaphoid fractures diagnosed with CT/MRI and bonescintigraphy were treated with a six-week scaphoid forearm cast. Within 1 year after cast removal patients filled in the DASH questionnaire. Results: Sixty (80%) patients returned the DASH questionnaire at 12 months after treatment. Thirty-eight (63.3%) were male and the mean age was 35 (range 11 - 83). Forty-four (73.3%) patients had a mid-waist fracture of the scaphoid, 13 (21.7%) had a fracture of the distal pole and three (0.05%) had a proximal fracture. Median DASH score at one year after the trauma was 6 (range 3 - 15) for patients with a distal pole fracture and 5 (range 0 - 21.5) for mid-waist fractures (p = 0.7, table 2). For the three patients with a proximal scaphoid fracture the DASH scores appeared higher and were 83, 82 and 30 respectively. Conclusion: Conservative treatment for six weeks with a below the elbow cast is sufficient for the majority of patients with an occult distal or mid-waist scaphoid fracture and results in a good functional outcome according to the DASH questionnaire.

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Drijkoningen, T. , Beeres, F. , Leerdam, R. , Ootes, D. , Grootendorst, D. , Otoide-Vree, M. and Rhemrev, S. (2012) Functional outcome in conservatively treated non-displaced scaphoid fractures. Open Journal of Clinical Diagnostics, 2, 66-69. doi: 10.4236/ojcd.2012.24015.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Rhemrev, S.J., de Zwart, A.D., et al. (2010) Early computed tomography compared with bone scintigraphy in suspected scaphoid fractures. Clinical Nuclear Medicine, 35, 931-934. doi:10.1097/RLU.0b013e3181f9de26
[2] Buijze, G.A., Mallee, W.H., et al. (2011) Diagnostic performance tests of suspected scaphoid fractures differ with conventional and latent class analysis. Clinical Orthopedics and Related Research, 469, 3400-3407. doi:10.1007/s11999-011-2074-9
[3] Beeres, F.J., Hogervorst, M., et al. (2005) Outcome of routine bone scintigraphy in suspected scaphoid fractures. Injury, 36, 1233-1236. doi:10.1016/j.injury.2005.02.009
[4] Clay, N.R., Dias, J.J., et al. (1991) Need the thumb be immobilised in scaphoid fractures? A randomised prospective trial. The Journal of Bone & Joint Surgery, 73, 828-832.
[5] Lindstrom, G. and Nystrom, A. (1990) Incidence of post- traumatic arthrosis after primary healing of scaphoid frac- tures: A clinical and radiological study. Journal of Hand Surgery, 15, 11-13.
[6] Vinnars, B., Pietreanu, M., et al. (2008) Nonoperative compared with operative treatment of acute scaphoid frac- tures. A randomized clinical trial. The Journal of Bone & Joint Surgery, 90, 1176-1185. doi:10.2106/JBJS.G.00673
[7] Green, D.P. (1999) Operative Hand Surgery, 4th Edition, Churchill Livingstone, New York.
[8] Vinnars, D.P., Singh, H.P., et al. (2009) The clinical outcome of scaphoid fracture malunion at 1 year. Journal of Hand Surgery, 34E, 40-46.
[9] Buijze, G.A., Doornberg, J.N., et al. (2010) Surgical comparedwith conservative treatment for acute nondisplaced or minimally displaced scaphoid fractures: A systematic review and meta-analysis of randomized controlled trials. The Journal of Bone & Joint Surgery, 92, 1534-1544. doi:10.2106/JBJS.I.01214
[10] Haddad, F.S. and Goddard, N.J. (1998) Acute percutaneous scaphoid fixation. A pilot study. The Journal of Bone & Joint Surgery, 80, 95-99. doi:10.1302/0301-620X.80B1.8076
[11] Langhoff, O. and Andersen, J.L. (1988) Consequences of late immobilization of scaphoid fractures. The Journal of Bone & Joint Surgery, 13, 77-79.
[12] Leslie, I.J. and Dickson, R.A. (1981) The fractured carpal scaphoid. Natural history and factors influencing outcome. The Journal of Bone & Joint Surgery, 63-B, 225-230.
[13] McQueen, M.M., Gelbke, M.K., et al. (2008) Percutaneous screw fixation versus conservative treatment for fractures of the waist of the scaphoid: A prospective randomised study. The Journal of Bone & Joint Surgery, 90, 66-71. doi:10.1302/0301-620X.90B1.19767
[14] Geissler, W.B., Adams, J.E., et al. (2012) Scaphoid fractures: What’s hot, what’s not. The Journal of Bone & Joint Surgery, 94, 169-181. doi:10.2106/JBJS.942icl

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