Methods of Cast Immobilization for Nondisplaced Scaphoid Fractures and the Evaluation of Fracture Union
M. Agarwal, MS, FRCS; Charles D. Bond, MD; Alexander Y. Shin, MD; Mark T. McBride, MD; Khiem D. Dao, MD

To The Editor:

Regarding “Percutaneous Screw Fixation or Cast Immobilization for Nondisplaced Scaphoid Fractures” (2001;83:483-8) by Bond et al., I wish to comment on the methods used in this study.

The patients in Group II (cast immobilization) had the fractures treated with a long-arm thumb-spica cast followed by a short-arm thumb-spica cast. This regimen seems excessive and unnecessary, as a previous study by Clay et al.1 showed that a below-the-elbow (short-arm) Colles-type plaster cast is adequate for treatment of fresh nondisplaced fractures of the scaphoid.

Perhaps the longer time taken for rehabilitation and return to full-duty status by patients in Group II was due to the excessively prolonged immobilization, which, as previously mentioned, is unnecessary.

Bond et al. stated that they reevaluated all patients at one week after the start of treatment and subsequently at two-week intervals until the fracture healed. At each follow-up visit, the wrist was examined for snuffbox tenderness and radiographs were made. Do the authors mean to state that, for patients in Group II, at each visit, …


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