Summary
Limited evidence from one small randomized controlled trial (RCT) suggests that a
higher fracture union rate is achieved when intramedullary screw fixation is used
compared with nonoperative cast treatment in athletes. Faster recovery times and quicker
return to sports were also reported for patients who had operative treatment compared
with nonoperative treatment in the RCT. While a higher union rate was reported in
a retrospective cohort as well, results were not statistically significant and because
of the methodological limitations of this study, greater weight should be placed on
the RCT findings. A multicenter randomized controlled trial may provide sufficient
sample size for more effective comparison of the two methods of treatment.
