Houston Methodist. Leading Medicine

Hand FAQ


If a broken wrist (on the side of the thumb) can be treated by either cast or surgery, why would surgery be picked over casts since there are more risks to surgery?


If someone breaks the scaphoid bone, the wrist bone that is at the base of the thumb, doctors often have a choice of treatment. In some cases, surgery is essential because of how severe the break is, but if the break isn't complicated, they may have the choice of casting or surgery. If both treatment options are equally acceptable, the surgeons should take into consideration other issues, such as how old the patient is, how well he would do with surgery, how well she would cope with a cast for an extended period of time, what the occupation is, and so on. These can all play a part in deciding which treatment plan to follow. Someone who is very healthy otherwise and is in a rush to return to work, but who can't work with a bulky cast, may opt for surgery to heal more quickly. On the other hand, if the person can work with the cast because of the type of job he or she has, then the cast may be a better option. Risks for complications do exist, but this is also something that is taken into account when any surgery is performed. Ashwin N. Ram, BS, and Kevin C. Chung, MD. Evidence-Based Management of Acute Nondisplaced Scaphoid Waist Fractures. In The Journal of Hand Surgery. April 2009. Vol. 34. No. 4. Pp. 735 to 738.

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