Office management of scaphoid fractures.
A dull, deep pain in the wrist after a fall on an outstretched hand is the hallmark of a scaphoid fracture. Pain with maneuvers that stress the scaphoid can suggest fracture on physical exam. Radiographs are crucial: Determining the location, stability, and orientation of the fracture guides treatment and predicts outcome. Distal fractures and horizontally oriented fractures generally heal well and can be managed by immobilization in a short-arm thumb spica cast. Proximal fractures and vertically oriented fractures have the most morbidity, and open reduction should be considered. When prolonged immobilization is required, range-of-motion and strengthening exercises are prescribed to restore hand function after cast removal.
Gutierrez
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The Denver Center for Sports and Family Medicine, Denver, CO, 80206, USA.