Most experts advise surgery to correct the problem. Without treatment, the bone can collapse causing deformity and later, joint damage. If the blood supply is disrupted, the bone can also die.
Casting the wrist and arm is not recommended based on other research in this area. A long arm cast is needed to stabilize the bone for healing. Healing can take up to six months or more. During that time, you can lose wrist and elbow motion, which can affect your overall function and quality of life.
Even patients who are symptom-free are advised to have this operation. This is because there is plenty of evidence to show a link between nonunion fractures and osteoarthritis later on.
There are a few reasons why this operation is not recommended. If the patient is an older adult and/or smokes, surgery may be too risky for the benefit it would provide. Surgery to correct the problem may not be a good idea if the wrist has already collapsed. In such cases, the bone may be removed instead of repaired.