If the fracture of the scaphoid is through the waist and the bone has tilted forward, or if the fracture is through the proximal (forearm end) part of the scaphoid, then often open surgery is recommended. Depending on the fracture site this is done via a cut across the front or back of the wrist, clearing out any scar tissue from the fracture, positioning some fresh bone from the back of the wrist or the hip, and then placing a screw across the fracture site.
This surgery is done as a day case procedure under general or regional anaesthetic. Afterwards the wrist is placed into a plaster cast for six weeks, and then a removable splint for another six weeks. During the second six weeks the splint can be removed for gentle wrist exercises.
For more info:-
Scaphoid fractures – Rupert Wharton
References:-
Davis TRC Ann R Coll Surg Engl 2013; 95: 171–176 doi 10.1308/003588413X13511609956895