Suggested Method for Closed Treatment of Fractures of the Carpal Scaphoid: Hypothesis Supported by Dissection and Clinical Practice

The anatomy and kinetics of the carpus with special reference to the fractured scaphoid are described. Clinical, radiological and post-mortem studies of the wrist show that the scaphoid can be immobilized and compressed in its long axis, with the wrist held in full supination, mid-dorsiflexion and full ulnar deviation. Immobilization of the upper limb in this position for four weeks has achieved union of those fractures of the scaphoid which are often problematical, i.e. the displaced fracture, fractures of the proximal pole, and those exhibiting delay in union of many months. The method of manipulation and immobilization in a plaster of Paris cast is described, and some clinical examples are presented. The indications for the complications of the method of treatment are discussed and briefly compared with other methods of treatment.