- Falling on an Out-Stretched Hand (FOOSH) is the most common mechanism of wrist injuries, with the wrist in extension.
- Immature, weaker epiphyseal plate or metaphysis of the radius in children are more likely to sustain injuries, sparing the still-cartilaginous carpal bones.
- Young adults with active lifestyles are more likely to be injured with greater forces.
- In the elderly, especially in women with some degree of osteoporosis, distal radial metaphysis is more fragile resulting in Colles fracture.
- “Anatomic snuffbox’’ on the dorsum of the wrist is an important landmark. Because the scaphoid is palpable with its triangle by styloid, extensor pollicis brevis tendon and the extensor pollicis longus tendon. Tenderness in this area may indicate a scaphoid fracture. The image above shows scaphoid fracture.
- The examination should include assessment of neurovascular status motor and sensory function of the median, radial and ulnar nerves. Because acute median nerve compression is a common occurrence, the sensation of thumb and index fingers is important, especially with severely displaced fractures. In all injuries to the wrist, radial and ulnar pulses should be evaluated.
Further reading
Upper extremity injuries
iEM Education Project Team
January 2, 2019
Cite this article as: iEM Education Project Team, "iEM Image Feed: Scaphoid fracture," in International Emergency Medicine Education Project, May 12, 2021, https://iem-student.org/2021/05/12/iem-image-feed-scaphoid-fracture/, date accessed: October 1, 2023
