How is a nondisplaced scaphoid fracture typically treated?

• A. Thumb spica cast immobilization for 6–12 weeks
• B. Short-arm cast for 3 weeks
• C. No immobilization needed
• D. Wrist fusion

Answer: (A)

Immobilize the wrist and thumb in a thumb spica cast for about 6–12 weeks. Nondisplaced scaphoid fractures heal best when movement at the fracture site is minimized because the scaphoid has a tenuous blood supply and is prone to delayed healing or nonunion if the bone is allowed to move. The thumb spica cast effectively restricts motion across the fracture, promoting proper alignment and ossification during the healing period. A short-arm cast that doesn’t immobilize the thumb wouldn’t control motion well enough, and no immobilization would prevent healing. Wrist fusion is not appropriate for a simple nondisplaced fracture, as it sacrifices wrist motion for a problem that can usually heal with proper immobilization.