Wrist Pain “Snuff Box” TendernessFindings? Course of Action / Confirmation Studies?

Answers
Scaphoid Fracture (Occult)

• Initial Radiographs showed a questionable fracture of the scaphoid waist, in a patient who is symptomatic in that area
• MRI and bone scan confirmed scaphoid fracture present (alternatively, re-examine after 2 and 6 weeks in short-arm-splica cast)
• Most frequent (90%) carpal fracture, missed from 25-65% of time!
• Prognosis depends on location of Fx: 90% nonunion it Fx involves proximal 1/3
• Complications: AVN, degenerative arthritis