Tier 6

Principles

Vascular watershed area with high non-union risk (15-30%) in non-operative management. Union approaches 100% for those managed operatively.

Even if union achieved, there is high risk of re-fracture (33%).

Management

Most are suitable for trial of non-operative management.

• Non-weightbearing in walking boot or cast for 8 wks.
• Transfer to walking boot (to be weaned over 2-4 wks) providing there are signs of clinical and radiographical union at 8 weeks.