Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with persistent radial-sided wrist pain following a remote scaphoid fracture. Reports localized tenderness in the anatomical snuffbox, decreased grip strength, and limited range of motion. No history of recent acute trauma; symptoms are chronic and progressive.
Clinical Examination Findings
Inspection reveals mild swelling and atrophy of the thenar eminence. Palpation demonstrates point tenderness over the scaphoid tubercle and within the anatomical snuffbox. Range of motion is restricted in flexion/extension and radial deviation. Pain elicited with axial loading of the thumb. Neurovascular status intact distally.
Treatment Protocol
Plan includes advanced imaging (CT scan) to assess nonunion gap and sclerosis. Discussion regarding surgical intervention, including open reduction internal fixation (ORIF) with bone grafting (e.g., vascularized or non-vascularized graft) to promote union. Immobilization in a thumb spica splint pending surgical scheduling.