1. Scaphoid Fracture Case Study
Joni Canter, MBA, ATC
Steadman Hawkins Clinic of the Carolinas
South Carolina School for the Deaf and the Blind

2. 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

3. 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

4. Scaphoid Fracture Case Study Initial Radiographs

5. Scaphoid Fracture Case Study
Treatment:
thumb spica splint
f/u with Dr. Pappas for surgical evaluation in next 2-3 days

6. 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

7. Scaphoid Fracture Case Study
Surgery performed the next day
Procedure:
ORIF with headless compression screw via dorsal approach

8. Scaphoid Fracture Case Study
2 week post-op visit:
X-rays:
healing scaphoid fracture in excellent position
Treatment:
thumb spica cast

9. Scaphoid Fracture Case Study 2 wks post-op

10. Scaphoid Fracture Case Study
6 week post-op visit
X-rays:
healed fracture
Treatment:
removable thumb spica splint
return to activities as tolerated

11. Scaphoid Fracture Case Study 6 wks post-op

12. Thank you!