Open volar repair of acute scaphoid fractures.

Internal fixation of acute scaphoid fractures has significant advantages over conservative treatment, using cast immobilization. Healing rates are improved, functional recovery is accelerated, and morbidity is reduced. Percutaneous fixation has become the treatment of choice for the majority of acute fractures, since it is an out-patient procedure, which produces virtually no scarring and enables an extremely-rapid recovery; however, in those cases where a stable and anatomical reduction cannot be achieved by closed means, open volar repair remains the best method of treatment. With careful attention to technique, and the avoidance of postoperative immobilization, excellent results can be achieved, even in the case of transscaphoid fracture-dislocation of the carpus.