Acute non-displaced fractures of the scaphoid: earlier return to activities after operative treatment. A controlled multicenter cohort study.
BACKGROUND
To investigate whether operative treatment leads to earlier return to previous activity level, 94 patients with the same number of isolated, acute, complete, stable and non-displaced fractures of the scaphoid mid-third were involved in a prospective, multicenter cohort study.


METHODS
Fractures were either fixed with a cannulated screw or immobilized with a short arm cast, and followed for 6 months.


RESULTS
By 15 weeks, patients receiving surgical treatment returned significantly earlier to their full time work and home activities, as well as achieved significantly better results for functional status, pain, and overall satisfaction. However, complication rates concerning union and secondary operative management were higher.


CONCLUSIONS
Operative treatment therefore primarily facilitates earlier return to previous activity level, as well as better functional status, less pain and higher patient satisfaction, yet conservative treatment seems to be safer and associated with a lower complication rate.
Schädel-Höpfner
Michael
M
Department of Trauma and Hand Surgery, University Hospital, Moorenstrasse 5, Düsseldorf, Germany. schaedel@uni-duesseldorf.de
Marent-Huber
Marta
M
Gazyakan
Emre
E
Tanzer
Karin
K
Werber
Klaus D
KD
Siebert
Hartmut R
HR
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001863:Bone Screws; D002370:Casts, Surgical; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D050723:Fractures, Bone / Q000534:rehabilitation* / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D020127:Recovery of Function; D018570:Risk Assessment; D021361:Scaphoid Bone / Q000293:injuries*; D016896:Treatment Outcome; D055815:Young Adult