A FOOSH injury with snuff box tenderness indicates which fracture?

A FOOSH injury with snuff box tenderness indicates which fracture?

• A. Lunate Fracture
• B. Scaphoid Fracture
• C. Capitate Fracture
• D. Hamate Fracture

Answer: (B)

A fall on an outstretched hand causing pain in the anatomic snuffbox most strongly signals a scaphoid fracture. The scaphoid sits right under the snuffbox, so this area becomes tender when the bone is injured, making it the classic finding after FOOSH. Other carpal fractures can occur, but they don’t typically present with snuffbox tenderness as the defining clue—lunate fractures tend to cause broader wrist pain and risk carpal complications, capitate fractures are less common and often relate to axial loads with different pain patterns, and hamate fractures produce ulnar-sided pain near the hypothenar region. Because initial X-rays can be normal with scaphoid injuries, management should include immobilizing the wrist in a thumb-spica splint if suspicion is high and obtaining further imaging (MRI or repeat X-rays in 1–2 weeks). The scaphoid’s blood supply makes proximal fractures particularly prone to avascular necrosis and nonunion if not identified and treated promptly.

A fall on an outstretched hand causing pain in the anatomic snuffbox most strongly signals a scaphoid fracture. The scaphoid sits right under the snuffbox, so this area becomes tender when the bone is injured, making it the classic finding after FOOSH. Other carpal fractures can occur, but they don’t typically present with snuffbox tenderness as the defining clue—lunate fractures tend to cause broader wrist pain and risk carpal complications, capitate fractures are less common and often relate to axial loads with different pain patterns, and hamate fractures produce ulnar-sided pain near the hypothenar region. Because initial X-rays can be normal with scaphoid injuries, management should include immobilizing the wrist in a thumb-spica splint if suspicion is high and obtaining further imaging (MRI or repeat X-rays in 1–2 weeks). The scaphoid’s blood supply makes proximal fractures particularly prone to avascular necrosis and nonunion if not identified and treated promptly.