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Occult scaphoid fracture — ACEM Fellowship MCQ

Instant feedback + full explanation. One question, done properly.

HardMusculoskeletal/Orthopaedic emergenciesOccult scaphoid fractureACEM Fellowship

A 43-year-old presents 14 hours after a deep dog bite to the dorsum of her hand. The wound is punctured and swollen, and finger movement is painful. Which management is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Wound irrigation with hand-surgery assessment

Explanation lettering: B = shown as A · E = shown as B · A = shown as E

E is correct. A delayed puncture wound to the hand with painful movement needs thorough irrigation and hand-surgery assessment for deep injury. Debridement and infection management follow that assessment. The alternatives do not adequately manage hand-bite risk.

Reference: NSW Agency for Clinical Innovation: Dog and cat bites clinical tool: https://aci.health.nsw.gov.au/networks/eci/clinical/tools/dog-cat-bites