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Occult scaphoid fracture — ABEM Board MCQ

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EasyMusculoskeletal/Orthopedic emergenciesOccult scaphoid fractureABEM Board

A 24-year-old man arrives as ESI 3 after falling on an outstretched hand. Vitals are normal. He has anatomic snuffbox tenderness and pain with axial thumb loading; initial wrist radiographs are negative. Which of the following is the most appropriate next step in management?

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Correct answer: C — Place a thumb spica splint and arrange repeat imaging or follow-up

Clinically suspected scaphoid fracture requires thumb spica immobilization despite negative initial films because occult fracture and avascular necrosis are concerns.

Reference: Tintinalli Emergency Medicine; ACR Appropriateness Criteria wrist trauma