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Occult scaphoid fracture — RCPSC EM MCQ

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EasyMusculoskeletalOccult scaphoid fractureRCPSC EM

A 21-year-old falls on an outstretched hand. Wrist radiographs are normal, but there is anatomic snuffbox tenderness and pain with axial thumb loading. Neurovascular examination is normal. What is the most appropriate disposition?

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

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Correct answer: D — Immobilise in a thumb spica splint and arrange follow-up imaging or fracture clinic review

Immobilise in a thumb spica splint and arrange follow-up imaging or fracture clinic review is correct: the clues indicate Occult scaphoid fracture and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: Canadian fracture emergency practice