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If neglected or misdiagnosed, non-union of a scaphoid fracture will almost inevitably progress to radiographic and symptomatic osteoarthritis of the wrist with subsequent morbidity and lifelong disability, especially in young males in which the fracture is more common. Fractures of the scaphoid bone are the most common fractures of the carpus and second in occurrence among fractures of the wrist. The diagnosis and treatment are not simple. Familiarity with different imaging methods and treatment options is required. The treatment in most cases is conservative and will lead to uneventful union, but an operation may be needed in certain cases primarily and in the treatment of non-union. The current literature on the diagnosis and treatment of scaphoid fractures is reviewed, and the authors try to make a clear and concise picture of this complex and sometimes controversial field.

The longterm results of surgical and conservative treatment in two almost identical groups of patients with fractures of the ankle have been analyzed. The results were better after conservative treatment; delayed operation and repeated manipulations were found to be the main reason for the poorer postoperative results, especially in elderly osteoporotic patients. The damage consequent to repeated manipulations, the difficulties resulting from delaying operation, and the advantages of early open reduction are discussed. It may be that under certain conditions of unavoidable delay, a mild residual displacement should be accepted rather than repeated manipulation and delayed open reduction. It is concluded that, when indicated, operations should be performed as early as possible after injury, probably giving the best end results as evidenced by the preliminary findings of a prospective study currently under way.