Page 36 - 2021 IDMT Digital

SCAPHOID FRACTURE
Introduction:
• 7KH VFDSKRLG LV WKH PRVW FRPPRQO\ IUDFWXUHG ERQH RI WKH ZULVW DQG LV SURQH WR SRRU
RXWFRPHV HYHQ LI LGHQWLILHG SURSHUO\
o 7KH VFDSKRLG KDV D SRRU EORRG VXSSO\ ZKLFK FDQ OHQG LWVHOI WR DYDVFXODU QHFURVLV
• $ IDOO RQ RXWVWUHWFKHG KDQG ("FOOSH") LV WKH PRVW FRPPRQ PHFKDQLVP RI LQMXU\

Subjective:
• 6LJQV DQG 6\PSWRPV
o 3DLQ DW EDVH RI WKH WKXPE
o *ULS VWUHQJWK ZHDNHQLQJ DQG SDLQ ZLWK JULS
o 6ZHOOLQJ
• )RFXVHG +LVWRU\
o +DQG GRPLQDQFH
o 0HFKDQLVP RI LQMXU\
o +LVWRU\ RI ZULVW LQMXU\
Objective:
• 3K\VLFDO ([DP
o 6ZHOOLQJ HFFK\PRVLV
o $QDWRPLFDO VQXIIER[ 773
o 3RVLWLYH VKXFN WHVW SDLQ ZLWK D[LDO ORDGLQJ
o 'HFUHDVHG 520
o 'HFUHDVHG JULS VWUHQJWK
• 7RROV
o ; UD\V RI KDQG DQG ZULVW DW WLPH RI LQMXU\ ZLWK ILOPV UHSHDWHG LQ ZHHNV
Assessment:
• 'LIIHUHQWLDO
o 'H 4XHUYDLQ¶V WHQRV\QRYLWLV SRVLWLYH )LQNOHVWHLQ WHVW LQVLGLRXV RQVHW
o :ULVW DUWKULWLV XQOLNHO\ LQ D \RXQJ RWKHUZLVH KHDOWK\ SDWLHQW
Plan:
• ,I PHFKDQLVP RI LQMXU\ VXJJHVWLYH RI VFDSKRLG IUDFWXUH (even if initial negative x-ray)
o $YRLG DJJUDYDWLQJ DFWLYLWLHV
o 7KXPE VSLFD VSOLQW
o 5,&(
o 16$,'V QDUFRWLFV IRU SDLQ
o (9$& RU WUDQVIHU
• ,I PHFKDQLVP RI LQMXU\ OHVV VXVSLFLRXV
o 7KXPE VSLFD VSOLQW
o 5,&(
o 16$,'V
o If certified in Battlefield Acupuncture (BFA) and with preceptor concurrence,
consider administering up to 10 treatment sessions as an alternative to
NSAIDs as long as there is clinical benefit and no worsening of the patient’s
condition

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