Direct and indirect costs in the conservative management of undisplaced scaphoid fractures

The scaphoid is the most commonly fractured carpal bone, and preferable treatment of undisplaced fractures is controversial. In order to assess the socio-economic impact of treatment modalities, we analysed the cost of conservative management of 54 undisplaced scaphoid fractures. Global costs amounted to 14.077 Swiss francs (9385 euros) per patient. Direct costs represent only 10% of global costs. No significant correlation was found between costs and timing of diagnosis, hand dominance or complications. Thirty-four percent of patients were able to resume their job with the wrist immobilised without complication, but at an obvious impact on indirect and global costs. If early resumption of professional activities during conservative treatment of undisplaced scaphoid fractures does not impair successful fracture healing, patients should be encouraged to return to work as early as possible, as is routinely done after percutaneous fracture fixation. This will contribute to massively reducing the cost of conservative treatment.