scaphoid

Question 1

typical mechanism of injury for scaphoid fracture

Answer 1

FOOSH

contact sports

Question 2

blood supply to scaphoid bone

Answer 2

80% from dorsal carpal branch (branch of radial artery) in a retrograde manner

Question 3

signs of scaphoid fracture

Answer 3

pain along radial aspect of wrist, base of thumb

loss of grip/pinch strength

max tenderness in anatomical snuffbox (sensitive but not specific)

pain elicted by telescoping thumb (longitudal compression)

Question 4

definitive investigation to confirm/exclude scaphoid fracture

Answer 4

MRI
= first line following clinical examination

Question 5

initial management of suspected/confirmed scaphoid fracture

Answer 5

immobilisation with Futuro splint or standard below-elbow backslab

refer to ortho
- arrange follow up

Question 6

if images are inconclusive for scaphoid fracture - next step?

Answer 6

review + further imaging in 7-10days

Question 7

management of undisplaced fractures of scaphoid waist

Answer 7

cast for 6-8weeks

(professional sports people may benefit from early surgical intervention)

Question 8

maangement of displaced scaphoid waist fractures

Answer 8

requires surgical fixation

Question 9

management of proximal scaphoid pole fractures

Answer 9

require surgical fixation

Question 10

complications of scaphoid fractures

Answer 10

non-union -> pain + early OA

AVN