A review of scaphoid fracture healing in competitive athletes.

A fractured scaphoid is a common disabling injury occurring in contact sports. Plaster immobilization is the most frequently used form of therapy. However, the rules governing most amateur sports do not allow an unyielding form of immobilization distal to the elbow. We describe a method of treating scaphoid fractures with custom-made Silastic (Dow Corning Wright, Arlington, TN) casts for competitive athletes. A retrospective review of 14 scaphoid fractures occurring in athletes competing in contact sports was completed to determine if effective immobilization could be maintained with this technique. The study covered a 10 year period with an average followup of 3.9 years (range 2 to 9 years). Ten of 11 middle third scaphoid fractures healed uneventfully. One nonunion occurred following a 7 week delay in diagnosis. Two of three proximal third scaphoid fractures went on to nonunion, while the third healed after a prolonged period of treatment. Our data indicate that nondisplaced middle third scaphoid fractures can be effectively immobilized for competition in contact sports with the custom-made Silastic cast described.