- Distal radius fracture
- Scaphoid fracture
- Lunate dislocation
This patient suffered a scaphoid fracture—one of the most common injuries associated with a fall on outstretched hands (FOOSH).
Learnings/What to Look for
- Scaphoid fractures are the most common carpal bone fracture. They occur most often in adolescents and young adults
- The fracture location is most often through the waist
- Examine the anatomical snuff box and if there is pain, consider a scaphoid fracture
- These injuries may be subtle or occult. If there is strong clinical suspicion after a negative XR, consider MRI.
Pearls for Urgent Care Management and Considerations for Transfer
- Imaging should include multiple views, including lateral, PA, oblique, and ulnar deviation
- Suspicion of scaphoid fracture should be treated as a confirmed fracture until proven otherwise
- The patient should be placed into a thumb spica splint before discharge
- Follow up should be in 5-7 days with repeat imaging if subjective or objective pain persists
Acknowledgment: Images courtesy of Teleradiology Specialists.