What is a significant indicator for a high risk of scaphoid fracture following injury?

• A. Wrist swelling
• B. Presence of snuff box tenderness
• C. Joint stiffness
• D. Excessive bruising

Answer: (B)

The presence of tenderness in the anatomical snuff box is a significant indicator of a high risk for a scaphoid fracture following an injury. The snuff box, located on the radial side of the wrist, is formed by the tendons of the extensor pollicis longus and the abductor pollicis longus. Tenderness in this area after a wrist injury raises suspicion for a fracture of the scaphoid bone, which can be easily missed on initial assessment.

Scaphoid fractures are critical to identify early because they have a potential for non-union or complications due to the bone's precarious blood supply. If the fracture is not diagnosed and managed appropriately, it can lead to long-term issues such as avascular necrosis or chronic wrist pain.

While wrist swelling, joint stiffness, and excessive bruising may accompany wrist injuries, they are more nonspecific symptoms and do not directly correlate with scaphoid fractures as strongly as tenderness in the snuff box does. These other indicators can indicate various wrist injuries but lack the specificity needed for identifying a scaphoid fracture.