This study by Saedén and colleagues is unique in
its direct comparison of operative treatment and cast immobilization
for fractures of the scaphoid. Although the method and timing of
randomization are unclear, the two treatment groups appear comparable.
The radiographic follow-up is incomplete, but the absence after
12 years of any major symptoms of pain in the operative group, in
which the majority of degenerative changes were seen, suggests that
the radiographic evidence of osteoarthritis probably has limited