Comparative assessment of the outcome of the two different treatment approaches in the management of acute scaphoid fractures
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 9, Pages 3703-3710
AbstractAim: The aim of the present study was to evaluate the role of conservative vs operative treatment for acute scaphoid fractures.
Material and methods: This prospective observational study was carried out in the Department of Orthopaedics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pardesh, India from September 2015 to August 2016. Total 50 acute scaphoid fractures (<3 weeks) irrespective of the location and All scaphoid fractures as a part of other acute injuries like peri-lunate instabilities were included in this study. The clinical examinations consisted of three diagnostic tests: A. tenderness in the anatomical snuffbox (ASB); B. scaphoid tubercle tenderness (STT); and C. pain on longitudinal compression of the thumb (LTC). If any of these tests were positive, the patients were referred for a radiographic investigation of the wrist).
Results: A total of 50 cases of acute scaphoid fracture (</= 3 weeks) were seen in during study period. The average age of presentation in our study was 37.5 years. Most common mode of injury was Road traffic accident. Other causes of injuries were sports injury, work place injuries, house hold injuries, assault injury. Most common location of fracture was waist fracture (19 cases-3 incomplete & 16 complete) followed by distal oblique fracture (7 cases). 34 patients were managed conservatively & 16 patients were treated with operative procedure (CRIF/ORIF WITN K-Wire / Herbert screw). Mayo wrist score was calculated for all patients in follow up.
Conclusion: the choice of operative or nonoperative treatment must be individualized based on the discussion of pros and cons of treatment with the patient. Non-operative treatment has good results in case of acute, non-displaced stable fractures through the scaphoid waist and in distal pole without other bony or ligamentous injury and for scaphoid fractures in children.
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