Acutrak screw fixation versus cast immobilisation for undisplaced scaphoidwaist fractures

Fifty-three patients with less than 14 day-old, undisplaced fractures of th e waist of the scaphoid were randomized to two groups. Twenty-eight patient s were treated by immobilisation in a below elbow plaster cast for 10 weeks while 25 were treated by percutaneous insertion of an Acutrak standard scr ew. There were no statistically significant differences between the two tre atment groups with regard to either the rate of union or the time to union. Patients who underwent surgery had a significantly better range of motion at 16 weeks hut there were no significant differences for grip strength. Ac ute percutaneous internal fixation of undisplaced scaphoid waist fractures using the Acutrak screw allows early mobilisation without adverse effects o n fracture healing.