Scaphoid Fracture
Medgeeks with Andrew Reid
Medgeeks
4.8 • 997 Ratings
🗓️ 3 February 2020
⏱️ 16 minutes
🧾️ Download transcript
Summary
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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Transcript
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| 0:00.0 | A 43 year old male presents to the emergency department with right wrist pain after falling on his outstretched right hand. |
| 0:07.0 | You obtain an x-ray of the wrist which demonstrates no acute fracture or dislocation. |
| 0:12.0 | The patient is |
| 0:13.4 | neurovascularly intact. You decide to discharge the patient home |
| 0:16.8 | with instructions to treat with ice, rest, and some neproxin. |
| 0:21.2 | Fourteen months later, you are being sued by this very same patient. |
| 0:25.6 | Apparently, after you saw the patient, their wrist pain never got better, |
| 0:29.2 | and in fact it persisted for over eight months before they were finally seen again at another facility. |
| 0:34.2 | They were then referred on to hand surgery where the diagnosis of a scaphoid fracture |
| 0:39.0 | with osteonechrosis 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 in limited functionality of the hand. |
| 0:50.0 | So they're unable to make a living as a plumber and their quality of life has dropped significantly. |
| 0:54.6 | This is a fictional story, but very, very common. |
| 0:58.7 | Today we're going to talk about how to diagnose and how to not get burned by scaphoid fractures. Welcome to the med geeks podcast. This is Eric Gordon your host and today I was just |
| 1:22.0 | really in an ortho kind of mood, I guess, because we're going to be talking about scaphoid fractures. |
| 1:27.5 | And we also had a question sent in from AskMedgecom that I'm going to be answering regarding shoulder pathology. |
| 1:34.3 | So if you like ortho, awesome. |
| 1:36.2 | If you don't like ortho, give me a chance to change your mind today. |
| 1:39.5 | Let's do it. |
| 1:40.5 | Let's start with a little bit of anatomy review. |
| 1:42.0 | The scaphoid is one of the carpal bones. |
| 1:44.9 | It's in the proximal row of carpal bones in the wrist and it's on the radial side or the thumb side. |
| 1:50.8 | It articulates with the distal radius as well as the adjacent carpal bones, which would be the lunate, capitate, trapezoid, and trapezium. |
... |
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