A 28-year-old man falls onto an outstretched hand and develops wrist pain localized to the anatomical snuffbox. Initial radiographs are negative. After 2 weeks of thumb spica cast immobilization, repeat radiographs remain negative but he has persistent snuffbox tenderness. MRI confirms a non-displaced scaphoid waist fracture. The recommended definitive management is:
- A Continue cast immobilization for another 4 weeks
- B Open reduction and internal fixation with a plate
- C Percutaneous scaphoid screw fixation ✓
- D Excision of the proximal pole and silicone replacement
Correct answer: C. Percutaneous scaphoid screw fixation
Explanation
Non-displaced scaphoid waist fractures can be treated conservatively with cast immobilization, but percutaneous screw fixation is increasingly favored even for stable fractures to allow earlier return to function and reduce non-union risk. ORIF with plate is not used for scaphoid. Proximal pole excision is for AVN salvage.
Reference: Rockwood and Green's Fractures in Adults, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.