Fractures & Trauma · NEET PG Preparation Orthopaedics
A 32-year-old construction worker falls from a ladder and sustains an injury to his right wrist. Examination reveals swelling, pain, and tenderness s…
Practice question from Fractures & Trauma (NEET PG Preparation Orthopaedics), with the correct answer and a step-by-step solution.
medium · MCQ · Q-3BD283
A 32-year-old construction worker falls from a ladder and sustains an injury to his right wrist. Examination reveals swelling, pain, and tenderness specifically in the anatomic snuffbox, along with pain on axial compression of the thumb. Initial plain radiographs of the wrist show no obvious fracture. What is the most appropriate next step in management?
- A.Discharge with reassurance and advise no imaging is needed
- B.Apply a thumb spica cast and obtain follow-up radiographs or advanced imaging in 10-14 daysCorrect answer
- C.Perform open reduction and internal fixation immediately
- D.Order a standard bone scintigraphy immediately
Solution
Scaphoid fractures are notoriously occult on initial plain radiographs. If clinical suspicion is high (snuffbox tenderness), the standard management is to immobilize the wrist in a thumb spica cast and repeat radiographs or perform an MRI/CT in 10-14 days when bone resorption at the fracture site makes it visible.
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