59 articles examining the efficacy and risks associated with nonoperative and operative management of acute scaphoid fracture were reviewed to summarize the evidence pertaining to operative and conservative management of the condition. This process analyzed 4 level 1 studies that revealed no significant differences between groups when comparing nonunion, time to union (insufficient data for meta-analysis) and complications (insufficient data for meta-analysis). This meta-analysis and systematic review demonstrated that the current literature on the treatment of acute scaphoid fractures is of poor quality and is limited by flaws such as inconsistent definitions for union.