Question

A patient presents with swelling and tenderness in the anatomical snuffbox after sustaining a fall on their outstretched hand. The image given below shows the cast used to manage the patient’s injury. Identify the fracture.

• A. Colle’s fracture
• B. Scaphoid fracture
• C. Smith fracture
• D. Galeazzi fracture

Hint:

Scaphoid fractures are often missed initially on X-ray. If there is tenderness in the anatomical snuffbox, especially after trauma, a CT scan or MRI may be required for confirmation.

Answer 1

The Correct Option is B

Colle’s fracture: This is a fracture of the distal radius, usually occurring from a fall on an outstretched hand with the wrist in extension. The fracture results in dorsal displacement of the distal fragment, but the anatomical snuffbox is not typically involved in this type of fracture.
Scaphoid fracture: This is the correct answer. Scaphoid fractures are the most common type of wrist fracture following a fall on an outstretched hand. The scaphoid bone is located in the anatomical snuffbox, and tenderness in this area after a fall is highly suggestive of a scaphoid fracture. X-rays may initially appear normal, and the fracture may be visible only after several days.
Smith fracture: This is a reverse Colle’s fracture, where the distal fragment of the radius is displaced ventrally (towards the palm) instead of dorsally. It is usually caused by a fall with the wrist in flexion, which is not the case here.
Galeazzi fracture: This is a fracture of the radius with dislocation of the distal radioulnar joint. It typically results from a direct blow to the forearm or a fall, but it does not specifically involve the anatomical snuffbox, and the injury mechanism is different from a scaphoid fracture. Thus, the correct answer is Scaphoid fracture (2), as it involves tenderness in the anatomical snuffbox following a fall on an outstretched hand.