Surgical treatment versus conservative treatment in stable acute scaphoid fractures: systematic review

Background: regarding carpal fractures, scaphoid fractures are among the most common. The approach to this type of fracture can be surgical or non-surgical, the treatment depends on factors that include mainly the degree of displacement of the bone fragment, joint instability, and the location of the fracture within the anatomy of the bone. The surgical approach or conservative treatment generates great questions when choosing the best method for the treatment of stable scaphoid fractures, with conservative management currently being the most widely used. The systematic review aims to determine whether surgical treatment can supplant orthopedic treatment. Material and methods: a manual literature search was performed in the PubMed database during the period from 2004 to 2022. The keywords included "Scaphoid Bone"; “Fractures, Bone” and "Therapeutics". The titles, abstracts and full articles were examined, extracting the data. Fourteen articles consisting of systematic reviews and meta-analyses were selected, as well as five publications composed of "Randomized Controlled Trial" and "Clinical Trial" studies. No language restrictions were applied. Results: five jobs were selected after applying the inclusion and exclusion criteria, two groups were formed, one that underwent surgical treatment and the other a conservative approach. The time of return to work was evaluated being faster in surgical treatment versus conservative, as well as complications in both treatments, with surgical approach having the highest rate of complications. Conclusion: surgical treatment has a high rate of complications, which must be evaluated when selecting it as a therapeutic option, being at the same time the one that brings the best results in terms of early return to work or sports activity. On the other hand, conservative treatment appears to be safer, with a lower rate of complications, but a later return to work.