Objective: To describe the evaluation, diagnosis, and progressive treatment for a student who sustained a scaphoid fracture while mountain biking. Background: Scaphoid fractures are often difficult to diagnose due to inconsistency of symptom criteria compared to other types of fractures. Additionally, additional x-ray imaging may be needed to identify a scaphoid fracture. Treatment: Wrist immobilization followed by rehabilitation for structural integrity, pain-free range of motion, and muscle strengthening of the forearm and wrist muscles. Differential diagnosis: muscle strain, wrist sprain, scaphoid dislocation, arthritis, De Quervain syndrome. Conclusion: Scaphoid fracture is a common sports injury and the most common carpal fracture of the wrist. Scaphoid fractures often go undiagnosed or are misdiagnosed due to the lack of signs and symptoms typically found in a bone fracture. For this reason, taking x-rays or MRIs is important for a correct diagnosis and rehabilitation plan.___________________________________________________________The scaphoid is one of the eight carpal bones of the wrist. It is bounded distally by the triquetrum, trapezius and capitate, medially by the lunate and proximally by the styloid process of the radius. It can be found by palpating the anatomical snuffbox of the hand or the lateral area of the wrist formed by the extensor inchi longus, extensor inchilis brevis, abductor inchus longus, and the styloid process of the radius. A year-old male NMU ROTC student presented to the clinic with right wrist pain. The patient had no previous injuries to his right wrist or right arm. The onset of the injury occurred one month earlier, at the end of August, and the mechanism of injury was falling on an outstretched hand on a fixed rock while mountain biking. During evaluation, the patient reported a dull, aching pain scoring 4 out of 10 at rest on the pain scale and 8 out of 10 during use. The patient also reported sharp pain when performing activities, such as push-ups, turning the doorknob, and shaking hands. Objective evaluation of the patient's right wrist revealed mild swelling and abrasion on the right thenar eminence. Point tenderness over the right scaphoid, trapezius, capitate, and lunate along with the thenar eminence has been reported. The range of motion tests decreased for active movements for all wrist movements, particularly with radial deviation, and only extension improved with passive movements. Pain was present during all movements. Special tests performed initially did not indicate a wrist fracture.
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