Pain in the anatomic snuffbox after FOOSH most strongly suggests fracture of which carpal bone?

Pain in the anatomic snuffbox after FOOSH most strongly suggests fracture of which carpal bone?

• A. Lunate
• B. Capitate
• C. Scaphoid
• D. Trapezium

Answer: (C)

Pain in the anatomic snuffbox after a fall on an outstretched hand points to a fracture of the scaphoid because this bone forms the floor of the snuffbox. Tenderness there is a classic sign of scaphoid injury, given its position right beneath the snuffbox. The scaphoid’s blood supply comes from vessels that enter distally and flow proximally, so a fracture—especially of the proximal pole—can compromise blood flow and lead to avascular necrosis or nonunion even if initial X-rays look normal. That’s why a high index of suspicion persists: imaging may be negative early, yet the injury can still be real. Management often starts with immobilization in a thumb spica cast, and alternative imaging (MRI or CT) is pursued if symptoms persist or if radiographs are inconclusive. Fractures of the lunate, capitate, or trapezium don’t classically present with snuffbox tenderness after a fall, so the snuffbox finding most strongly indicates a scaphoid fracture.

Pain in the anatomic snuffbox after a fall on an outstretched hand points to a fracture of the scaphoid because this bone forms the floor of the snuffbox. Tenderness there is a classic sign of scaphoid injury, given its position right beneath the snuffbox.

The scaphoid’s blood supply comes from vessels that enter distally and flow proximally, so a fracture—especially of the proximal pole—can compromise blood flow and lead to avascular necrosis or nonunion even if initial X-rays look normal. That’s why a high index of suspicion persists: imaging may be negative early, yet the injury can still be real. Management often starts with immobilization in a thumb spica cast, and alternative imaging (MRI or CT) is pursued if symptoms persist or if radiographs are inconclusive.

Fractures of the lunate, capitate, or trapezium don’t classically present with snuffbox tenderness after a fall, so the snuffbox finding most strongly indicates a scaphoid fracture.