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Acute fractures of the scaphoid. Treatment by cast immobilisation with the wrist in flexion or extension?
Hambidge JE, Desai VV, Schranz PJ, Compson JP, Davis TR, Barton NJ
Journal of Bone and Joint Surgery -- British Volume 1999 Jan;81-B(1):91-92
clinical trial
3/10 [Eligibility criteria: No; Random allocation: No; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Acute fractures of the scaphoid were randomly allocated for conservative treatment in a Colles'-type plaster cast with the wrist immobilised in either 20 degrees flexion or 20 degrees extension. The position of the wrist did not influence the rate of union of the fracture (89%) but when reviewed after six months the wrists which had been immobilised in flexion had a greater restriction of extension. We recommend that acute fractures of the scaphoid should be treated in a Colles'-type cast with the wrist in slight extension.

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