2. Pmx- Routine
childhood illnesses
Allergies- Sulfa
Social- No ETOH or
Tobacco
Family Hx- HTN
PSX- Appendectomy
HPI - 15 y/o male
presents to ED
complaining of right
hand pain after falling
on an outstretched,
dorsiflexed hand.
H & P
3. P- 102 BP -122/80 RR -12 O2- 99 %
HEENT- NCAT, EMOI
Resp- CTAB
EXT- forearm exam- Normal, Pain in the anatomic
snuffbox. Pulses intact.
4.
5. - Scaphoid Fracture!!!!
Fractures of the scaphoid occur in people of all ages,
including children. The injury often happens during
sports activities or a motor vehicle accident. Men
aged 20 to 30 years are most likely to experience
this injury.
6. Thumb Spica
Pain medication
Orthopedic referral
Note: Any patient with pain in the
anatomical snuff box should be placed
in a Thumb Spica Splint, regardless of
X-ray findings
7. Scaphoid fractures usually cause pain and
swelling at the base of the thumb. The pain may
be severe when you move your thumb or wrist,
or when you try to grip something.
Unless your wrist is deformed, it might not be
obvious that the scaphoid bone is broken. In
some cases, the pain is not severe, and may be
mistaken for a sprain.
Any pain in the wrist that does not go away
within a day of an injury may be a sign of a
fracture.