A 15-year-old male presented to the emergency department complaining of right hand pain after falling on an outstretched, dorsiflexed hand. On examination, he had normal vital signs and findings except for pain in the anatomical snuffbox area of the right forearm. Suspecting a scaphoid fracture, the patient's hand was placed in a thumb spica splint, he was prescribed pain medication, and referred to orthopedics. Scaphoid fractures usually cause pain and swelling at the base of the thumb that is worsened with thumb or wrist movement or gripping. Any wrist pain that persists after an injury may indicate a fracture.

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.

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.