Rethinking Scaphoid Fixation

There is a lack of consensus regarding scaphoid fracture and nonunion management. Recent litera-ture suggests that more stable fixation, such as dual screw fixation or plate fixation, when indi-cated, may allow for earlier mobilization or faster time to union. Stability and biology are important to fracture healing. The need for vascularized bone grafting has not been proven, and less demanding techniques may yield similar out-comes. The quality of available literature on scaphoid fracture and nonunion outcomes is limited by heterogenous cases and reporting. Future studies could better guide surgeons by clearly reporting definitions of nonunion and dys-vascularity, fracture and nonunion characteristics, and clear definition of union.