PV Card: Adult scaphoid fracture

Feb 01, 16
PV Card: Adult scaphoid fracture

snuffbox tenderness scaphoid fractureWhat is the most commonly fractured carpal bone in adults? It’s the scaphoid bone. As a bonus it has the dreaded complication of avascular necrosis. So how good are the physical exam and imaging modalities in diagnosing a fracture? What is the likelihood ratio (LR) that snuffbox tenderness predicts a fracture? Bottom lines: The exam is highly sensitive but poorly specific, such that one can only confidently state that a NON-tender snuffbox and scaphoid tubercle essentially rule out an acute scaphoid fracture. Also negative x-rays for patients with scaphoid tenderness still yield a fracture post-test probability of 25%. This PV card breaks down all the LRs.1

PV Card: Scaphoid Fracture


Adapted from 1

Reference

  1. Carpenter C, Pines J, Schuur J, Muir M, Calfee R, Raja A. Adult scaphoid fracture. Acad Emerg Med. 2014;21(2):101-121. [PubMed]

Author information

Sean Kivlehan, MD MPH

Sean Kivlehan, MD MPH

Associate Director
International Emergency Medicine Fellowship
Department of Emergency Medicine
Brigham and Women's Hospital
Harvard Medical School

The post PV Card: Adult scaphoid fracture appeared first on ALiEM.

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