Orthopedic pitfalls in the ED: Scaphoid fracture

Wrist injuries are frequently encountered in the emergency department. When a patient presents with such an injury, the possibility of scaphoid fractu re must be at the top of the differential for the emergency practitioner. U nfortunately, these injuries can be missed on first presentation, as they a re frequently radiographically occult. When left unrecognized and untreated , these injuries lead to a high incidence of long-term functional disabilit y and chronic pain. The emergency physician needs to be vigilant for scapho id fracture and be aggressive in both its diagnosis and treatment to avoid this practice pitfall. This review examines the clinical presentation, diag nostic techniques, and management options applicable to the emergency physi cian. (Am J Emerg Med 2001;19:310-316, Copyright (C) 2001 by W.B. Saunders Company).