Scaphoid Fracture Case StudyJoni Canter, MBA, ATC
Steadman Hawkins Clinic of the Carolinas
South Carolina School for the Deaf and the Blind
Scaphoid Fracture Case Study
CC: R wrist pain
HPI: 19F RHD basketball player presents with right wrist pain x 1 week s/p fall onto outstretched hand during a game
PMH: deaf student at the SC School for the Deaf & the Blind, no hx of wrist or hand injuries
Scaphoid Fracture Case Study
Physical Exam RUE:
No swelling or bruising TTP over anatomic
snuffbox Opposition + Thumb extension + Wrist flexion + Wrist extension + Tap test +
Assessment: Suspected scaphoid
fracture
Plan: Splint Ice Refer for x-ray within
next 1-2 days
Scaphoid Fracture Case Study Initial Radiographs
Scaphoid Fracture Case Study
Treatment: thumb spica splint f/u with Dr. Pappas for surgical evaluation
in next 2-3 days
Scaphoid Fracture Case Study
Dr. Pappas Visit: Assessment:
displaced scaphoid fracture with mild flexion healing potential reduced given displacement most reliable option for bone union = surgery
Scaphoid Fracture Case Study
Surgery performed the next day Procedure:
ORIF with headless compression screw via dorsal approach
Scaphoid Fracture Case Study
2 week post-op visit: X-rays:
healing scaphoid fracture in excellent position Treatment:
thumb spica cast
Scaphoid Fracture Case Study 2 wks post-op
Scaphoid Fracture Case Study
6 week post-op visit X-rays:
healed fracture Treatment:
removable thumb spica splint return to activities as tolerated
Scaphoid Fracture Case Study6 wks post-op
Thank you!
