Acute non-displaced fractures of the scaphoid: earlier return to activities after operative treatment. A controlled multicenter cohort study
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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.
Fractures were either fixed with a cannulated screw or immobilized with a short arm cast, and followed for 6 months.
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.
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.
KeywordsScaphoid fracture Operative treatment Convervative treatment Return to activities Return to work
The authors would like to thank all participating study centers and the following lead clinical investigators for their dedication in conducting this study: T. Pillukat (Bad Neustadt), A. Eisenschenk (Berlin), K.H. Winker (Erfurt), G. Böhringer (Giessen), J.M. Rueger (Hamburg), H. Towfigh (Hamm), R. Arora (Innsbruck), E. Brück (Marburg), K. D. Werber (München), R. Slodicka (Rosenheim).
Furthermore, the authors would like to thank L. Audigé (AOCID) for statistical advice and M. Wilhelmi (AOCID) and D. De Faoite (AOCID) for linguistic review.
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