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Questions regarding the evidence guiding treatment of displaced scaphoid fractures

Scaphoid fracture usually occurs in younger people during their most productive years. Most fractures are nondisplaced and 85–90% of scaphoid fractures unite in a below-elbow plaster cast. The incidence of reported displacement is around 10–29% (Clay et al., 1991, Cooney et al., 1980) but this depends on the definition. Mostly, investigation and management of scaphoid fractures follows widely accepted, established methods. As is found in many aspects of hand surgery, these traditional methods of decision-making are often supported by low-quality evidence. We explore conventional perceptions and consider the current uncertainties in the management of displaced acute scaphoid fractures.