SWIFFTLancet (London, England) 2020
Surgery versus cast immobilisation for adults with a bicortical fracture of the scaphoid waist (SWIFFT): a pragmatic, multicentre, open-label, randomised superiority trial.
There was no clinically or statistically significant difference in PRWE at one year between early fixation and casting. Complications potentially linked to surgery were more frequent in the fixation group, whereas the cast group needed occasional later fixation for non-union.
Randomised trialManagementWrist
Buijze thumb immobilisation RCTThe Journal of hand surgery 2014
Cast immobilization with and without immobilization of the thumb for nondisplaced and minimally displaced scaphoid waist fractures: a multicenter, randomized, controlled trial
The cast excluding the thumb produced significantly greater extent of union on CT at 10 weeks; overall union was almost universal and there were no significant differences in motion, grip, wrist scores or pain.
Randomised trialManagementWrist
PRC vs four-corner fusion reviewThe Journal of hand surgery, European volume 2009
Proximal row carpectomy vs four corner fusion for scapholunate (Slac) or scaphoid nonunion advanced collapse (Snac) wrists: a systematic review of outcomes
Pain relief, grip strength and satisfaction were broadly similar between the two salvage procedures; four-corner fusion had more complications, while proximal row carpectomy carried a higher risk of later radiocapitate arthritis.
Systematic review / meta-analysisManagementWrist
Dias scaphoid fixation RCT 2005The Journal of bone and joint surgery. American volume 2005
Should acute scaphoid fractures be fixed? A randomized controlled trial.
Early fixation offered no lasting functional advantage over casting by one year, although some early benefits in function were seen. Non-unions in the cast group united after subsequent fixation, and surgery carried its own complications.
Randomised trialManagementWrist