舟骨固定术
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腕骨骨折经空心加压螺钉内固定术后的保护性康复计划：在螺钉的保护下，于愈合缓慢的骨痂连接期间尽早恢复腕关节活动度；随后逐步进行握力与力量训练；在确认骨折愈合前，避免负重及接触性运动。
本方案由基兰·希尔帕拉（Kieran Hirpara）医生在罗克汉普顿 Mater 私人医院为您制定，用于指导舟骨骨折（腕部深处一块小船形小骨的骨折，使用埋入式空心加压螺钉进行固定）手术后的康复过程。方案首先介绍您的家庭锻炼计划，随后是专为您的手部治疗师编写的结构化临床方案。请在首次治疗时携带此页面或其 PDF 版本，以确保您的康复过程协调一致。您的手部治疗师可能会根据您的骨折情况、固定方式以及康复进展对计划进行调整。
如果您对术后伤口有任何疑虑，请与诊所联系。拍摄伤口照片并通过电子邮件发送以供审查通常很有帮助。
预期情况
舟骨是位于腕部底部的一块小骨，连接腕骨的两排。它的血液供应方式特殊且脆弱，血流从一端向另一端逆向进入，因此舟骨骨折愈合缓慢，若不予处理，有时可能无法愈合（即骨不连）。舟骨内固定术使用一枚完全埋入骨内的空心加压螺钉将两块骨片牢固固定；患者无法触及螺钉，也无需取出。螺钉对骨折端施加压力，既有助于愈合，又使腕关节能够比单纯石膏固定治疗时更早开始活动。如果骨折为陈旧性骨折或已发生骨不连，可能会添加一小块骨移植材料（通常取自邻近的前臂骨）以促进愈合；这可能导致早期计划稍显保守。
康复的核心理念是：螺钉负责固定，而骨骼缓慢愈合。由于舟骨愈合缓慢，本计划中的里程碑节点是根据骨骼愈合情况而非仅按日历时间安排的。 您的外科医生通常通过X线检查，并常辅以CT扫描，确认骨折已愈合（“骨性愈合”）后，才会允许您进行更重的负荷活动和运动。进展速度取决于骨折的类型和位置（靠近愈合缓慢的近端，即“近极”的骨折，以及既往骨不连的情况需更加谨慎）以及固定的稳定性。
活动度在谨慎的阶段中逐步恢复：立即开始手指和拇指活动；在手治疗师允许后开始轻柔的腕关节活动；仅在骨骼愈合后进行握力和力量训练；最后才恢复负重或对抗性运动。由于修复组织在数月内持续成熟，较重的负荷和运动是逐步恢复的，而非一次性进行。
注意事项与限制
- 请按照指示佩戴夹板或石膏，并保持其干燥。Hirpara 医生和您的手部治疗师会告知您何时可以取下夹板进行锻炼，以及何时可以完全摘下。
- 在被告知骨折已愈合之前，切勿用力握持、提举、搬运或推举重物；挤压和负重会使正在愈合的舟骨和螺钉承受应力。
- 避免强行将手腕向后弯曲至完全背伸（伸展），早期应避免活动的极端范围；循序渐进地恢复活动范围，不要强行推向极限。
- 在您的外科医生确认骨骼已连接并允许之前，切勿恢复接触性、碰撞性或负重运动（或进行健身/举重、俯卧撑、球拍类或棍棒类运动）；这通常需要数月，而非数周。
- 从开始就保持手指、拇指、肘部和肩部的活动，以防止僵硬；在舒适范围内，可将手部用于日常轻度活动，前提是这些活动不涉及握持、提举或强行活动手腕。
- 如果您的内固定手术同时使用了骨移植治疗骨不连，预期恢复时间会更加谨慎；请严格遵循您的外科医生和手部治疗师制定的具体计划。
关于伤口、肿胀和瘢痕管理，请参阅诊所的伤口护理指南。
您的锻炼
这些是您讲义中的锻炼项目。仅在 Hirpara 医生和您的手部治疗师的指导下开始进行，并严格遵循您被允许的关节活动范围和限制。早期锻炼旨在保持手指、拇指和前臂的活动，同时不干扰舟骨的愈合；腕关节的轻柔活动仅在您的治疗师允许后方可加入。握力强化属于后期阶段，在您被告知骨骼已愈合之前不得开始。如果任何锻炼引起腕部剧烈疼痛，请立即停止并告知您的治疗师。
您的临床方案
本页面其余部分为经空心加压螺钉固定舟骨后的分阶段康复临床方案。本节内容将提供给患者的手部治疗师，每个阶段均以通俗易懂的语言解释当前的治疗情况。由于舟骨血供较差（呈逆行性），愈合缓慢，因此康复进展以骨折愈合为节点，且取决于内固定类型与骨折情况：对于稳定的急性腰部骨折，刚性螺钉固定允许更早进行受保护的腕关节活动；而近极骨折、骨折不愈合及植骨病例则需采取更为保守的康复进程。
治疗前，请查阅手术记录和既往病史，并与主治外科医生沟通骨折类型（腰部与近极）、骨折为急性或骨折不愈合、是否使用植骨、内固定的稳定性以及确认愈合的计划影像学检查节点。手部治疗师将根据具体的骨折和内固定情况执行计划。以下时间为稳定螺钉固定的急性腰部骨折的典型参考时间；对于近极骨折、骨折不愈合及植骨固定病例，需采取更为谨慎的进展策略。
第一阶段 - 受保护的早期活动（第0至2周）
最初几周在保持手部活动的同时，保护伤口和内固定物。手腕置于夹板或短石膏中固定；手指、拇指和前臂从第一天起即可自由活动。通常在术后两周左右进行伤口复查，此时开始正式治疗。
供您手部治疗师参考：
教育与注意事项 - 按照外科医生的指示，使用腕部夹板或短石膏固定；保持干燥；仅在获准时取下 - 立即进行手指、拇指、肘部和肩部的完全主动活动度（ROM）练习，以预防僵硬 - 禁止通过手腕进行抓握、提举、负重或推撑 - 避免强迫性或终末范围的手腕背伸
管理 - 伤口：按指示进行外科敷料处理；监测感染迹象；约2周时复查伤口 - 水肿：抬高患肢，进行轻柔的手部泵式运动，必要时冰敷 - 锻炼：手指/拇指主动复合屈伸；拇指对指；轻柔的前臂旋前-旋后；肩部和肘部活动度练习
进阶标准 - 伤口愈合/正在愈合；疼痛缓解；获外科医生许可开始手腕活动
第二阶段 - 受保护的腕关节活动（第2至8周，以骨愈合为节点）
大约在术后两周（对于稳定的、螺钉固定的急性腕舟骨腰部骨折），在螺钉的保护下，开始引入舒适且无痛范围内的温和主动腕关节活动。活动范围逐渐增加；但仍需避免达到终末范围的伸展以及任何负重。近极骨折、骨不连以及植骨固定的病例需延长保护性制动时间，并在外科医生指导下稍晚开始活动。
致您的手部治疗师：
评估 - 主动腕关节活动度（ROM）、疼痛、肿胀；伤口/瘢痕复查；与外科医生沟通影像学检查及骨愈合情况
教育与注意事项 - 在无痛范围内开始温和的主动腕关节屈伸及桡尺偏；逐渐增加活动范围 - 避免终末范围/强迫性腕关节伸展，避免负重 - 在确认骨愈合之前，禁止握力强化、禁止负重、禁止抗阻训练 - 继续全范围的手指和前臂活动；伤口愈合后开始瘢痕管理
管理 - 练习：在舒适范围内进行主动及辅助主动腕关节活动度训练；继续手指/拇指/前臂活动度训练；进行水肿及瘢痕管理 - 本阶段早期若获建议，可在练习间隙佩戴夹板；解除制动由外科医生指导
进阶标准 - 影像学（通常经CT确认）骨愈合由外科医生确认；腕关节活动度舒适且可控；疼痛轻微。所有标准均满足后方可开始任何强化训练。
第三阶段 - 强化与重返运动（在确认骨性愈合后）
一旦外科医生确认骨折已愈合（急性腰部骨折通常在 8 至 12 周，而近极骨折和骨不连的愈合时间较晚），即可开始强化训练，并逐步增加强度：首先进行握力和塑形泥训练，然后进行渐进性的抗阻腕部和前臂强化，最后进行负重和专项运动训练。重返接触性、碰撞性和负重运动需基于标准并受骨性愈合情况限制，通常在约三至四个月之后，而对于高风险骨折则往往更晚。
供您的手部治疗师参考：
评估 - 与健侧对比的握力和捏力；腕关节活动度（ROM）；负重时的疼痛/肿胀反应；根据需要进行的功能性及运动/工作专项测试
教育与注意事项 - 仅在外科医生确认骨性愈合后开始握力和塑形泥强化；逐步增加负荷 - 增加渐进性抗阻腕部和前臂强化；随后进行分级负重和闭链训练 - 重返接触性/碰撞性/负重运动受骨性愈合情况限制且基于标准，通常在约 3-4 个月之后，近极骨折/骨不连者则更晚；在外科医生指示下，运动员早期受监督重返时可使用保护性夹板或石膏
管理 - 练习：分级握力/塑形泥 → 抗阻腕部和前臂强化（弹力带 → 轻重量） → 负重和专项训练；继续进行任何残留的活动度训练 - 一旦力量接近对称且功能恢复良好，可考虑出院 - 如果恢复出现平台期、疼痛持续或骨性愈合存疑（考虑延迟愈合/骨不连或无菌性坏死），请转诊回主治外科医生
重返运动标准 - 外科医生确认骨性愈合；无痛的全范围活动度（ROM）；接近对称的握力；无痛的专项运动负重和控制
重返工作与活动
鼓励从早期开始进行日常手部轻度活动（如进食、书写、穿衣、轻度自理），以舒适为度，前提是避免抓握、提举或强行活动腕关节。办公室及其他轻度非体力工作通常可较早恢复，有时在调整工作内容的情况下，于伤后1至2周内即可进行；而增加腕部负荷的重体力劳动则需待骨折愈合后，再逐步恢复。
由于您必须能够安全操控车辆，因此在佩戴限制腕部安全操控方向盘的石膏或夹板期间，或腕关节无法安全转向和抓握时，请勿驾驶。待去除限制性石膏，并经复诊确认您可自信且安全地操控车辆后，方可恢复驾驶。请在早期数周安排好交通协助。
通过腕部施加负荷（用力抓握、提举、推、压和拉）需待您的外科医生确认骨折愈合后，再逐步增加。重返接触性、碰撞性及负重运动以骨折愈合为前提，通常不早于伤后3至4个月，对于近极骨折及骨不连者往往更晚。是否恢复运动取决于经确认的愈合情况、无痛下完全活动度的恢复以及由Hirpara医生和您的手部治疗师评估得出的充分且对称的握力，而非仅依据日历时间。
协议之后
本协议与诊所的一般康复建议并行：请参阅术后疼痛管理、伤口护理和瘢痕管理。上述分阶段计划反映了舟骨固定术后的康复指南，您的持续康复将由Hirpara医生和您的手部治疗师根据您的骨折类型、固定方式以及手腕愈合情况个体化指导。
Evidence & references
Scaphoid Fixation — Fracture Fixation Outcomes & Post-operative Rehabilitation (Headless Compression Screw ± Bone Graft)
Topic scope: post-operative rehabilitation after internal fixation of a scaphoid fracture with a buried headless compression screw — percutaneous or open, for an acute fracture or for a nonunion (the latter usually with bone graft, e.g. distal-radius cancellous or vascularised graft). This is a fixation of a slow-healing bone, not a soft-tissue repair: rehabilitation is paced by bone union rather than by tendon/ligament healing windows, and the central tension is between the early-motion advantage that rigid screw fixation buys and the scaphoid's biological tendency to heal slowly and, when neglected, to fail to unite.
Defining principle of the rehab here: the scaphoid has a tenuous retrograde blood supply (it fills from distal to proximal), so it heals slowly and the proximal pole is at risk of delayed union, nonunion and avascular necrosis. A headless compression screw compresses and stabilises the fracture, which is what permits earlier protected wrist motion than a cast alone and earlier return to work/sport in suitable fractures. But the construct does not change the bone's biology: grip, loading and contact sport remain union-gated — held back until the surgeon confirms healing, commonly on CT. Progression is therefore fixation- and fracture-dependent: a stable, screw-fixed acute waist fracture mobilises early; a proximal-pole fracture, a nonunion, or a bone-grafted case is treated more cautiously. The hand therapist follows the plan for the specific fracture and fixation.
A. FIXATION OUTCOMES (acute fixation, and nonunion fixation with graft)
Headless compression screw fixation is a reliable operation with high union rates; the principal debates are who should be fixed acutely (vs cast) and how aggressively to mobilise, not whether the screw works.
- Headless compression screws give high union rates and earlier mobilisation. Internal fixation of scaphoid fractures with headless compression screws achieves high union in both non-displaced and displaced fractures, with the added benefits of earlier mobilisation and earlier return to work and sport compared with cast treatment [Fowler & Ilyas, Hand Clin 2010; Fowler & Hughes, Clin Sports Med 2015]. Moderate (narrative/technique reviews + cohort).
- Percutaneous screw fixation unites faster than cast for acute waist fractures. A randomised trial of 60 acute scaphoid-waist fractures found percutaneous Acutrak screw fixation reached union significantly faster than cast immobilisation (~9.2 vs ~13.9 weeks), with a trend to fewer nonunions [Bond et al., J Bone Joint Surg Br 2008]. Moderate–strong (RCT, single-centre).
- But surgery vs cast for minimally displaced waist fractures gives equivalent long-term function at the cost of more complications. The pragmatic multicentre SWIFFT RCT (bicortical, ≤2 mm displaced waist fractures) found no meaningful difference in wrist function between early surgical fixation and cast immobilisation (with fixation reserved for the cast fractures that failed to unite), while surgery carried more complications. Systematic reviews/meta-analyses concur: surgery favours union but raises complication risk, with ROM, grip and arthritis rates not significantly different [Dias et al., SWIFFT, Lancet 2020; Alshryda et al., The Surgeon 2012; Modi et al., Injury 2009; Rhemrev et al., Injury 2009]. Strong (RCT + SRs).
- Nonunion fixation with bone graft restores union in most cases but heals slower. Scaphoid nonunions treated with screw fixation and bone grafting (non-vascularised distal-radius, vascularised distal-radius, or two-screw constructs) achieve union in the large majority, with proximal-pole and avascular cases the hardest. Acute fixation unites ~100% vs chronic/nonunion ~87% in pooled experience [Garcia et al., J Hand Surg Am 2014; Ribak et al., Int Orthop 2009; Kim et al., Orthop Traumatol Surg Res 2018; Wu et al., Bone Joint J 2022; Simonian & Trumble, JAAOS 1994]. Moderate (cohort/SR).
- The elite/competitive athlete is a distinct decision. Early screw fixation is often favoured in athletes to compress the fracture, shorten immobilisation and enable earlier (often splinted) return to play, accepting the surgical risk for the time advantage [Belsky et al., Hand Clin 2012; Fowler & Hughes, Clin Sports Med 2015]. Moderate (expert/cohort).
B. REHABILITATION / THERAPY EVIDENCE
The rehab questions are (1) how soon to mobilise the wrist after rigid fixation, (2) when to permit loading/grip, and (3) when to confirm union and clear sport. The evidence supports early protected motion under the screw but keeps strengthening and sport union-gated, with proximal-pole/nonunion cases handled more conservatively.
- Rigid screw fixation permits earlier protected wrist motion than cast-alone. The mechanical rationale is that compression across the fracture confers stability, allowing the wrist to begin gentle motion while the bone unites; reported acute-fixation pathways start gentle mobilisation early with a ~2-week wound/therapy review and ~6-week radiographic check [Fowler & Ilyas, Hand Clin 2010; Fowler & Hughes, Clin Sports Med 2015]. Moderate (technique/expert).
- Union is the gate for loading — and it is slow and imaging-confirmed. Reported time to union ranges ~7–16 weeks depending on healing criteria, fracture site and population (athletes vs general), and CT is frequently used to confirm union before clearing loading and sport because plain films overestimate healing [Ecker, Hand Clin 2017 (scaphoid union); Fowler & Hughes, Clin Sports Med 2015]. Moderate.
- Proximal-pole fractures, nonunions and grafted cases progress more slowly. The proximal pole's poor vascularity means later union and a more cautious return; arthroscopic and open grafting series for nonunion report union but over longer timeframes [Wu et al., Bone Joint J 2022; Shih et al., J Orthop Surg Res 2023; Garcia et al., J Hand Surg Am 2014]. Moderate (cohort).
- Percutaneous/antegrade technique is a safe route that supports the early-motion pathway. The percutaneous antegrade approach minimises soft-tissue insult and supports the earlier-mobilisation rationale in suitable fractures [Weinberg et al., Injury 2009]. Moderate (cohort).
Recovery trajectory (expected, evidence-anchored)
| Phase | Window | Restraint | Hand use / therapy focus | Strength / load | Notes |
|---|---|---|---|---|---|
| I — Protected early motion | Week 0–2 | Wrist splint/short cast; no wrist loading | Immediate active finger/thumb/elbow/shoulder ROM; oedema control; wound review ~2 wk | None through the wrist | Hand kept supple; scaphoid undisturbed |
| II — Protected wrist mobilisation | Week 2–8 (union-gated) | No grip/loading; avoid end-range/forced extension | Gentle active wrist flexion-extension and deviation in pain-free range; gradual progression; forearm rotation; scar massage once healed | No resisted/grip work | For stable, screw-fixed acute waist fractures. Proximal-pole/nonunion/grafted: immobilise longer, mobilise later |
| III — Strengthening & return | After confirmed union (commonly ~8–12 wk acute waist; later for proximal pole/nonunion) | Restrictions lifted on union | Grip/putty → progressive resisted wrist/forearm → loaded & sport-specific | Graded to symmetrical grip | Contact/load sport union-gated, typically not before ~3–4 months, later for high-risk fractures; CT often confirms union |
(Phase windows are typical guides for a stable screw-fixed acute waist fracture, not trial-derived deadlines; proximal-pole, nonunion and bone-grafted fixations are paced more conservatively by the surgeon and hand therapist.)
C. KEY CONTROVERSIES / EVIDENCE QUALITY
- Screw fixation vs cast for the acute minimally displaced waist fracture. Fixation unites faster (Bond RCT: ~9 vs ~14 weeks) and returns athletes/workers sooner, but SWIFFT and meta-analyses show equivalent long-term wrist function with more complications from surgery for minimally displaced waist fractures. The defensible position is selective fixation (displacement, proximal pole, high-demand athlete/worker, patient preference) rather than routine surgery for every undisplaced waist fracture [Dias SWIFFT Lancet 2020; Bond JBJS Br 2008; Alshryda Surgeon 2012; Modi/Rhemrev Injury 2009]. Strong evidence of functional equivalence; moderate on the complication trade-off.
- Early motion vs continued immobilisation after fixation. Rigid compression is the rationale for earlier protected wrist motion than cast-alone, and reported pathways mobilise early — but there is no high-certainty trial defining the optimal mobilisation schedule, so timing is surgeon/ therapist protocol and fracture-dependent. Weak–moderate (mechanism strong, scheduling consensus).
- When is it united — and what confirms it. Time to union is wide (~7–16 weeks) and plain radiographs overestimate healing; CT is commonly used to confirm union before clearing loading and sport, which is the true gate for progression [Ecker Hand Clin 2017]. Moderate.
- Return-to-sport timing. Union-gated and fracture-dependent; competitive athletes may return earlier in a protective splint/cast at surgeon discretion, accepting risk, whereas proximal-pole and nonunion cases return later. Reported real-world return is typically months, not weeks [Belsky Hand Clin 2012; Fowler & Hughes Clin Sports Med 2015]. Moderate (expert/cohort).
- Nonunion and proximal-pole biology. The retrograde blood supply drives delayed union, nonunion and AVN risk; grafting (cancellous, corticocancellous, or vascularised) addresses biology but lengthens the timeline. Persistent pain or doubtful union warrants reassessment rather than more loading [Garcia JHS Am 2014; Ribak Int Orthop 2009; Kim OTSR 2018; Wu BJJ 2022; Simonian & Trumble JAAOS 1994]. Moderate.
D. EVIDENCE STRENGTH FLAGS (summary)
- STRONG (RCT / SR): equivalent long-term wrist function from surgery vs cast for minimally displaced acute waist fractures, with more complications from surgery (SWIFFT + meta-analyses); faster union with percutaneous screw fixation than cast (Bond RCT, ~9 vs ~14 weeks).
- MODERATE: high union rates and earlier mobilisation/return with headless compression screws; nonunion union rates with screw + bone graft (acute ~100% vs chronic ~87%); wide ~7–16-week union window and CT confirmation of union; athlete-specific early/splinted return.
- WEAK / CONSENSUS: the specific early protected-motion, union-gated phase schedule (mechanistically rationalised by rigid compression; exact timings are surgeon/hand-therapist protocol and fracture-dependent, not trial-derived); precise return-to-sport months.
CITATIONS
RAG corpus (180,000+ Orthopaedic articles)
- Fowler JR, Ilyas AM. Headless compression screw fixation of scaphoid fractures. Hand Clin. 2010. PMID: 20670800. DOI: 10.1016/j.hcl.2010.04.005
- Fowler JR, Hughes TB. Scaphoid fractures. Clin Sports Med. 2015. PMID: 25455395. DOI: 10.1016/j.csm.2014.09.011
- Belsky MR, Leibman MI, Ruchelsman DE. Scaphoid fracture in the elite athlete. Hand Clin. 2012. PMID: 22883862. DOI: 10.1016/j.hcl.2012.05.005
- Ecker J. Scaphoid union. Hand Clin. 2017. PMID: 28991580. DOI: 10.1016/j.hcl.2017.07.001
- Bond CD, Shin AY, McBride MT, Dao KD. Percutaneous screw fixation versus conservative treatment for fractures of the waist of the scaphoid: a prospective randomised study. J Bone Joint Surg Br. 2008. PMID: 18160502. DOI: 10.1302/0301-620X.90B1.19767
- Alshryda S, Shah A, Odak S, et al. Acute fractures of the scaphoid bone: systematic review and meta-analysis. The Surgeon. 2012. PMID: 22595773. DOI: 10.1016/j.surge.2012.03.004
- Modi CS, Nancoo T, Powers D, et al. Operative versus nonoperative treatment of acute undisplaced and minimally displaced scaphoid waist fractures — a systematic review. Injury. 2009. PMID: 19195652. DOI: 10.1016/j.injury.2008.07.030
- Rhemrev SJ, van Leerdam RH, Ootes D, et al. Non-operative treatment of non-displaced scaphoid fractures may be preferred. Injury. 2009. PMID: 19324359. DOI: 10.1016/j.injury.2008.10.028
- Weinberg AM, Pichler W, Grechenig S, et al. The percutaneous antegrade scaphoid fracture fixation — a safe method? Injury. 2009. PMID: 19380132. DOI: 10.1016/j.injury.2008.12.016
- Garcia RM, Leversedge FJ, Aldridge JM, et al. Scaphoid nonunions treated with 2 headless compression screws and bone grafting. J Hand Surg Am. 2014;39(7). PMID: 24793227. DOI: 10.1016/j.jhsa.2014.02.030
- Ribak S, Medina CEG, Mattar R, et al. Treatment of scaphoid nonunion with vascularised and nonvascularised dorsal bone grafting from the distal radius. Int Orthop. 2009. PMID: 19730861. DOI: 10.1007/s00264-009-0862-6
- Kim J, Yoon J, Baek H. Corticocancellous bone graft vs cancellous bone graft for the management of unstable scaphoid nonunion. Orthop Traumatol Surg Res. 2018. PMID: 29258960. DOI: 10.1016/j.otsr.2017.11.011
- Wu F, Zhang Y, Liu B. Arthroscopic bone graft and fixation for proximal scaphoid nonunions. Bone Joint J. 2022. PMID: 35909374. DOI: 10.1302/0301-620X.104B8.BJJ-2022-0198.R1
- Shih Y, Wu C, Shih J. Arthroscopic treatment of stable nonunion, unstable nonunion, or nonunion of the scaphoid with early degenerative radioscaphoid arthritis. J Orthop Surg Res. 2023. PMID: 36804865. DOI: 10.1186/s13018-023-03609-8
- Simonian PT, Trumble TE. Scaphoid nonunion. J Am Acad Orthop Surg. 1994. PMID: 10709008. DOI: 10.5435/00124635-199407000-00001
Scaphoid fixation / rehabilitation literature (URLs)
- Dias JJ, Brealey SD, Fairhurst C, et al. Surgery versus cast immobilisation for adults with a bicortical fracture of the scaphoid waist (SWIFFT): a pragmatic, multicentre, open-label, randomised superiority trial. Lancet. 2020. DOI: 10.1016/S0140-6736(20)30931-4. https://doi.org/10.1016/S0140-6736(20)30931-4
- SWIFFT protocol — Scaphoid Waist Internal Fixation for Fractures Trial. PMC. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4893284/
- Bond CD, Shin AY, McBride MT, Dao KD. Percutaneous screw fixation versus conservative treatment for fractures of the waist of the scaphoid. J Bone Joint Surg Br. 2008. PubMed. https://pubmed.ncbi.nlm.nih.gov/18160502/
- The headless compression screw — technical challenges in scaphoid fracture fixation. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC4796528/
- Arthroscopic-assisted screw fixation of scaphoid waist fractures vs conservative treatment — randomised trial, minimum 4-year follow-up. PubMed. https://pubmed.ncbi.nlm.nih.gov/25913660/
- Non-operative treatment versus percutaneous fixation for minimally displaced scaphoid waist fractures in high-demand young manual workers. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC4244556/
