title: [Operative versus conservative treatment of non-displaced fractures of the scaphoid bone. Results of a controlled multicenter cohort study].
abstract: OBJECTIVE
  Within a prospective, multicenter cohort study we investigated whether operative treatment of scaphoid bone fractures leads to earlier return to previous activity levels.
  
  
  METHODS
  Only isolated, acute, complete, stable and non-displaced fractures of the mid-third of the scaphoid bone were included. A total of 94 patients with the same number of fractures were recruited. In the operative group, fractures were fixed with a cannulated screw and had postoperative splint immobilization for a maximum of 1 week. In the conservative group a short arm cast was applied until fracture union was achieved. Both groups were followed for 6 months.
  
  
  RESULTS
  By 15 weeks patients receiving surgical treatment had returned significantly earlier to their full time work and home activities and achieved significantly better results for functional status, pain, and overall satisfaction. However, after screw fixation, complication rates concerning union and secondary operative management were higher.
  
  
  CONCLUSIONS
  Operative treatment primarily facilitates earlier return to previous activity levels, as well as better functional status, less pain and higher patient satisfaction, but conservative treatment seems to be safer and associated with a lower complication rate.
authors.affiliation: Klinik für Unfall- und Handchirurgie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland. schaedel@uni-duesseldorf.de
authors.forename: M
authors.initials: M
authors.lastname: Schädel-Höpfner
authors.forename: M
authors.initials: M
authors.lastname: Marent-Huber
authors.forename: M
authors.initials: M
authors.lastname: Sauerbier
authors.forename: T
authors.initials: T
authors.lastname: Pillukat
authors.forename: A
authors.initials: A
authors.lastname: Eisenschenk
authors.forename: H R
authors.initials: HR
authors.lastname: Siebert
mesh_terms: D000328:Adult; D001863:Bone Screws; D002370:Casts, Surgical; D015331:Cohort Studies; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D050723:Fractures, Bone / Q000175:diagnosis / Q000628:therapy*; D005599:Fractures, Ununited / Q000175:diagnosis / Q000628:therapy; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D021361:Scaphoid Bone / Q000293:injuries* / Q000601:surgery*; D013557:Switzerland; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000175:diagnosis / Q000628:therapy*; D055815:Young Adult
references.citation: J Bone Joint Surg Br. 2001 Mar;83(2):230-4
references.pmid: 11284571
references.citation: Handchir Mikrochir Plast Chir. 1992 Mar;24(2):62-6
references.pmid: 1582612
references.citation: BMC Musculoskelet Disord. 2006 May 11;7:41
references.pmid: 16689987
references.citation: Am J Sports Med. 1998 Jan-Feb;26(1):56-8
references.pmid: 9474402
references.citation: J Hand Surg Am. 2009 Apr;34(4):735-8
references.pmid: 19345880
references.citation: J Formos Med Assoc. 2007 Nov;106(11):887-93
references.pmid: 18063509
references.citation: Handchir Mikrochir Plast Chir. 2010 Feb;42(1):71-4
references.pmid: 20205070
references.citation: J Hand Surg Br. 1997 Feb;22(1):8-15
references.pmid: 9061514
references.citation: J Hand Surg Br. 2001 Jun;26(3):192-5
references.pmid: 11386765
references.citation: J Bone Joint Surg Br. 1998 Jan;80(1):95-9
references.pmid: 9460961
references.citation: Am J Ind Med. 2006 Mar;49(3):197-203
references.pmid: 16421918
references.citation: J Bone Joint Surg Br. 1984 Jan;66(1):114-23
references.pmid: 6693468
references.citation: J Hand Surg Br. 1999 Oct;24(5):586-90
references.pmid: 10597938
references.citation: Am J Ind Med. 1996 Jun;29(6):602-8
references.pmid: 8773720
references.citation: Ergonomics. 2001 Oct 10;44(12):1038-55
references.pmid: 11780727
references.citation: J Bone Joint Surg Am. 2000 May;82(5):633-41
references.pmid: 10819274
references.citation: J Hand Surg Am. 1990 Jul;15(4):557-64
references.pmid: 2380517
references.citation: J Bone Joint Surg Br. 1988 Mar;70(2):299-301
references.pmid: 3346310
references.citation: J Bone Joint Surg Am. 1994 Feb;76(2):249-52
references.pmid: 8113260
references.citation: J Hand Surg Am. 1989 Jul;14(4):679-87
references.pmid: 2787817
references.citation: J Hand Surg Br. 1995 Aug;20(4):551-6
references.pmid: 7595004
references.citation: Am J Sports Med. 1996 Mar-Apr;24(2):182-6
references.pmid: 8775117
references.citation: J Bone Joint Surg Am. 2008 Jun;90(6):1176-85
references.pmid: 18519309
references.citation: J Hand Surg Br. 2001 Aug;26(4):321-5
references.pmid: 11469833
references.citation: J Bone Joint Surg Am. 2001 Apr;83(4):483-8
references.pmid: 11315775
references.citation: J Rehabil Med. 2008 Jun;40(6):440-5
references.pmid: 18509558
references.citation: Am J Public Health. 1998 Nov;88(11):1630-7
references.pmid: 9807528
references.citation: J Bone Joint Surg Br. 2008 Jan;90(1):66-71
references.pmid: 18160502
references.citation: Med Care. 1992 Jun;30(6):473-83
references.pmid: 1593914
references.citation: J Bone Joint Surg Br. 1991 Jan;73(1):138-42
references.pmid: 1670499
references.citation: J Hand Surg Br. 1990 Feb;15(1):11-3
references.pmid: 2307868
references.citation: Unfallchirurg. 2000 Oct;103(10):812-9
references.pmid: 11098739
references.citation: J Bone Joint Surg Am. 2005 Oct;87(10):2160-8
references.pmid: 16203878
references.citation: Injury. 2006 Apr;37(4):340-8
references.pmid: 16483576
references.citation: Unfallchirurg. 1997 Oct;100(10):776-81
references.pmid: 9446231
references.citation: Injury. 2009 Mar;40(3):268-73
references.pmid: 19195652
references.citation: Handchir Mikrochir Plast Chir. 2000 Jul;32(4):271-6
references.pmid: 11036548