Scaphoid Fracture

Presentation

The patient (usually 14–40 years of age) fell on an outstretched hand (FOOSH) with the wrist held rigid and extended and now complains of decreased range of motion (ROM) and a deep full pain in the wrist, particularly on the dorsal radial side. Physical examination discloses no deformity or ecchymosis but shows pain with motion and palpation and often swelling. Swelling may be seen, especially in the anatomic snuff box, the hollow seen on the radial aspect of the wrist when the thumb is in full extension (between the tendon of the extensor pollicis longus and the tendons of the abductor pollicis longus and extensor pollicis brevis) ( Fig. 127.1 ). The pain, which may be mild, is worsened by gripping or squeezing.