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A 22-year-old male snowboarder falls on an outstretched hand and presents with the radiograph shown in Figure A. Which of the following techniques is MOST important in optimizing biomechanical fixation?
Using a screw placed in the central axis of the scaphoid into the subchondral bone
Using a supplementary K-wire transfixing the distal pole of the scaphoid to the capitate
Using a screw placed in the dorsal axis of the scaphoid into the subchondral bone
Using a larger diameter screw placed in the dorsal axis of the scaphoid
Using a larger diameter screw placed in the volar axis of the scaphoid
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Which of the following statements is TRUE about force transmission based on wrist position?
neutral wrist position decreases force through the lunate fossa
extended wrist position increases force through the lunate fossa
neutral wrist position increases force through the scaphoid fossa
extended wrist position increases force through the scaphoid fossa
wrist position has no effect on force transmission
An open dorsal approach for antegrade screw fixation of a nondisplaced scaphoid waist fracture differs in which of the following ways compared to a percutaneous dorsal approach?
Decreased risk of proximal pole AVN
Increased risk of posterior interosseous nerve injury
Decreased risk of injury to the APL tendon
Increased risk of injury to the EPL tendon
Decreased risk of screw prominence above subchondral bone
Percutaneous screw fixation for non-displaced scaphoid waist fractures has been shown to have which of the following differences compared to closed treatment?
Increased direct and indirect cost
Slower return to work
Higher union rates
Reduced time to fracture union
Improved motion and grip strength after 2 years
A 27-year-old professional cowboy is thrown from a bull during the rodeo and lands on his hand. No deformity is identified and the hand is completely neurovascularly intact. Pain is present upon palpation of the anatomic snuffbox. A radiograph is provided in Figure A. The cowboy wants to return to competitive riding tomorrow. Which of the following is the best next step in management?
Cock-up wrist splint and immediate return to sport as tolerated by pain
Steroid injection of the snuffbox, taping of the wrist and return to sport
Percutaneous screw fixation of the nondisplaced fracture
Scapholunate ligament repair and percutaneous pin fixation
A 35-year-old woman reports wrist pain after a fall onto an outstretched hand. On exam, she has focal tenderness over the wrist snuffbox. A radiograph and CT image are shown in Figures A and B. What is the proper treatment of her injury?
Rest, ice, elevation
Removable splint for comfort
Thumb spica cast
Open reduction, internal fixation
Vascularized bone grafting