However, in the case of scaphoid fractures, the pain-limited range of motion may be out of proportion to the injury unless the examiner specifically palpates for scaphoid tenderness at the anatomic snuffbox and proximal radial surface of the wrist. Note that patients with both Colles fractures and scaphoid fractures may present with pain with limited range of motion. The combination of snuffbox tenderness, scaphoid tubercle tenderness, and pain with axial compression is 100% sensitive for a scaphoid fracture. Pain, swelling, and tenderness (as well as bruising when present) are characteristic signs that point the examiner to the fracture. Like Colles fractures, scaphoid (navicular) fractures are usually caused by a fall onto an outstretched hand with the wrist in hyperextension, but they can result in other ways. Scaphoid fractures are most likely to occur in men who are 20 to 30 years of age. Fractures of the carpal bones account for approximately 6% of all fractures, and the scaphoid is the carpal bone fractured most often. Untreated scaphoid fractures may lead to instability, premature degenerative arthritis, and necrosis of the proximal scaphoid.Īs stated in the previous chapter, scaphoid fractures are the second most common fracture to the distal forearm/wrist (behind radial fractures). ![]() The scaphoid bone is located on the thumb side of the wrist.Injury often involves a fall onto an outstretched hand.
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