Immobilization protocols for nondisplaced scaphoid fractures have included the elbow, wrist, and thumb. This study attempts
to demonstrate whether or not immobilization of the thumb makes a difference in preventing motion at the scaphoid fracture
site. Using six fresh frozen forearm specimens, a transverse waist scaphoid fracture was created through a dorsal approach.
Metallic markers were imbedded on either side of the fracture. Sutures were secured to the flexor pollicus longus (FPL) and
extensor pollicus longus (EPL). Each specimen was loaded in extension and flexion by attaching 50-g weights to the EPL and
FPL, first with no casting, then with a short arm cast, and finally a short arm thumb spica cast. Angulation and displacement
at the fracture site were measured in the coronal, sagittal, and axial planes utilizing image reconstructions from computed
tomography. One-way ANOVA with repeated measures and Tukey–Kramer multiple comparison test post hoc analysis were used for
statistical evaluation. There was no significant difference in fracture angulation or rotation between spica and short arm
casts. There was a significant difference in angulation and rotation in all three planes when comparing between casting and
no casting,
p < 0.05. In our cadaveric model, wrist immobilization is crucial for nondisplaced scaphoid waist fractures, and short arm
casting was just as effective as thumb spica casting in preventing fracture displacement.
Keywords Scaphoid - Fracture - Immobilization - Spica cast - Displacement