Scaphoid Fracture

A 43 year old male presents to the emergency department with right wrist pain after falling on his outstretched right hand. You obtain an  x-ray of the wrist, which demonstrates no acute fracture or dislocation. The patient is neurovascularly intact, you decided to discharge the patient home with instructions to treat with: ice, rest, and some naproxen.

14 months later, you're being sued by this very same patient, apparently, after you saw the patient their wrist pain never got better and in fact it persisted for over 8 months before they were finally seen again at another facility. They were then referred on to hand surgery where the diagnosis of a Scaphoid Fracture with Osteonecrosis due to non-union was made. 

The patient is suing you because they say you missed the fracture and now they have chronic wrist pain and limited functionality of the hand, so they're unable to make a living as a plumber, and their quality of life has dropped significantly. This is a fictional story, but very very common. Today we're going to talk about how to diagnose and how to not get burned by Scaphoid Fractures.

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