A Faster Fix for Wrist FracturesFractures of the scaphoid--the small wrist bone near the base of the thumb--are the most common kind of injury to the small bones of the wrist (the carpals). Unless the bone has been completely moved out of place, casts are the tried-and-true way of mending scaphoid injuries. But a cast can take eight to 12 weeks to heal the fracture, and the wrist sometimes stays stiff after the cast is off, delaying return to work or sports. Is there a faster way to get the bone to heal?
In this study, researchers wanted to see whether an internal type of fixation--namely putting a screw into the broken bone--would get people back on the job more quickly than a cast. The study involved 25 active-duty military personnel who had fractured their scaphoid bone. The patients were mostly men around the age of 24. Fourteen of them wore a cast until their fractures healed. The other 11 had surgery to stabilize their wrists with a screw.
Patients who had surgery got better faster than those who only wore a cast. The patients in the surgery group healed in about seven weeks, as opposed to 12 weeks for patients with casts. Patients who had surgery were back on the job in eight weeks, compared to 15 weeks for the cast group. In other words, screw fixation cut recovery time nearly in half.
Both treatments had similar results when compared two years later. Patients in both groups had a nearly equal amount of movement in the wrist, had nearly equal grip strength, and were equally satisfied with their treatment.
From these results, the short-term outlook is that the screw provides a faster fix for fractures of the scaphoid bone. However, the authors caution that surgery is not for everyone. More research is needed to determine the risks and benefits of screw fixation for fractures of the scaphoid bone.
Charles D. Bond, MD, et al. Percutaneous Screw Fixation or Cast Immobilization for Nondisplaced Scaphoid Fractures. In The Journal of Bone and Joint Surgery. April 2001. Vol. 83-A. No. 4. Pp. 483-488.
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