A systematic review of the treatment of acute fractures of the scaphoid.

A systematic review of the literature identified eight trials comparing surgery with cast treatment and found no significant difference in pain, tenderness, cost, functional outcome or patient satisfaction. In the group treated surgically, the rate of non-union was three times less, there was a quicker return to function and grip strength and range of movement was also transiently better. There were, however, more complications among those treated surgically. No significant differences were reported in the two trials that compared above and below elbow casts or the trial that compared scaphoid and Colles' casts.