Emergency Medicine Board Bombs

4. Snuffbox of Doom- Scaphoid fractures

Nov 5, 2019
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INSIGHT

Physical Exam for Scaphoid Fracture

  • Pain in the anatomical snuffbox, especially with ulnar deviation and wrist hyperpronation, indicates a scaphoid fracture.
  • This maneuver isolates the scaphoid, increasing sensitivity and specificity.
ADVICE

Scaphoid Fracture Treatment

  • Treat scaphoid fractures with a thumb spica splint, even without visible fracture on imaging.
  • This is crucial due to the high risk of avascular necrosis and potential long-term disability.
INSIGHT

Scaphoid Fracture Prevalence and Risk

  • Scaphoid fractures are the most common carpal bone fractures (70%).
  • These fractures are susceptible to avascular necrosis due to poor perfusion.
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