Table 1.

Casting Outcomes. Evidence of optimal casting for nondisplaced scaphoid fractures.

Study	Purpose	Methods	Union rate (%)	Average Time to Union	Level of Evidence	Authors' Conclusions
Gellman et al. (1989)	To compare Above Elbow (AE) versus Below Elbow (BE) thumb-spica casts for nondisplaced fractures	51 patients randomized into two groups: 1) AE for 6 weeks followed by BE 2) BE	AE->BE: 28/28 (100%) BE: 21/23 (91%)††	AE->BE: 9.5 weeks BE: 12.7 weeks*	Ib Prospective data with randomization and control	6 weeks in an above-elbow thumb-spica cast followed by switch to below-elbow thumb-spica cast
Clay et al. (1991)	To compare immobilization of the thumb versus leaving the thumb free down to metacarpal	392 patients randomized into two groups: 1) Colles' cast with thumb free (C) 2) "Scaphoid" plaster cast (S)	C: 133/148 (90%) S: 129/143 (90%)‡	C: 9 weeks S: 9.6 weeks	Ib Prospective data with randomization and control	Undisplaced waist fractures should be treated with Colles' cast with thumb free
Hambidge et al. (1999)	To compare wrist flexion (F) versus wrist extension (E) with the use of a Colles' brace	121 patients randomized into two groups: 1) Colles' with 20° flexion (F) 2) Colles'with 20° extension (E)	F: 53/58 (91%) E: 55/63 (87%)	Unquantified; Wrist extension at 6 months: F=61°; E=73°*	Ib Prospective data with randomization and control	The wrist should be positioned in slight extension to regain full extension of wrist

^*p< 0.05;

^††Significance unquantified;

^‡Adapted from 'Table V' by adding “Definitely united” and “Probably united” (143 + 148 = 291; patient data missing)