Comparison of short and long thumb-spica casts for non-displaced fractures of the carpal scaphoid.
A prospective study was undertaken of fifty-one patients who were randomly assigned to treatment with either a long or a short thumb-spica cast for a non-displaced fracture of the carpal scaphoid. The duration of follow-up was at least until union; the average follow-up was twelve months. Twenty-eight fractures were treated with a long thumb-spica cast and twenty-three, with a short thumb-spica cast. The hands that initially were treated with a long thumb-spica cast were placed in a short thumb-spica cast after six weeks. Fractures that initially were treated with a long thumb-spica cast united at an average of 9.5 weeks and those that were maintained in a short thumb-spica cast, at an average of 12.7 weeks. There were no non-unions and two delayed unions in the fractures that initially were treated with a long thumb-spica cast, compared with two non-unions and six delayed unions in those that had only a short thumb-spica cast. Fractures of the proximal or middle third of the carpal scaphoid had a significantly shorter time to union when they were treated initially in a long thumb-spica cast. Fractures of the distal third did well regardless of the type of immobilization.(ABSTRACT TRUNCATED AT 250 WORDS)
Gellman
H
H
Department of Orthopaedic Surgery, University of Southern California, Los Angeles 90007.
Caputo
R J
RJ
Carter
V
V
Aboulafia
A
A
McKay
M
M
D000293:Adolescent; D000328:Adult; D002348:Carpal Bones / Q000293:injuries*; D002370:Casts, Surgical; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000150:complications / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D011897:Random Allocation; D013933:Thumb; D014945:Wound Healing