[27] Scaphoid Fracture Flashcards
What causes a scaphoid fracture?
FOOSH
What are the clinical features of a scaphoid fracture?
Pain in anatomical snuffbox and on telescoping the thumb
What imaging should be requested in a suspected scaphoid fracture?
Scaphoid x-ray view
What should be done if clinical history and exam suggest scaphoid fracture, but x-ray is normal?
Should initially be treated
Why should you treat a suspected scaphoid fracture even if x-ray is normal?
Because the fracture may become apparent on x-ray after 10 days due to localised decalcification
How should a scaphoid fracture be managed?
Place wrist in scaphoid plaster (beer glass position)
What should be done if the initial x-ray was negative in suspected scaphoid fracture?
The patient returns to fracture clinic after 10 days for re-xray
What is done if a scaphoid fracture is visible on the 10 week follow up x-ray?
Put in plaster for 6 weeks
What is done if a scaphoid fracture is not visible on x-ray at the 10 week follow up, and is not clinically tender?
Put in plaster for 2 weeks
What is done if a scaphoid fracture is not visible on x-ray at the 10 week follow up, and the patient is not clinically tender?
No plaster
What is the main risk of a scaphoid fracture?
AVN of the scaphoid
Why is there a risk of AVN in scaphoid fracture?
As the blood supply runs distal to proximal
How will AVN of the scaphoid present?
Stiffness and pain in the wrist
