QuestionSBA
QuestionChoice
This is incorrect. The triquetrum bone is too medial to be the bone broken in this question. The anatomical snuffbox occupies the lateral aspect of the hand (remember in anatomical position, the arm is supinated) and therefore tenderness in this area could not be explained by a triquetrum fracture.
10025827
c
Triquetrum fracture
QuestionChoice
This is correct. The examination findings show marked tenderness in the anatomical snuffbox and pain when "telescoping" the thumb. This, paired with an injury sustained from falling on an outstretched hand is a classic presentation of a scaphoid fracture. These are clinically important as the scaphoid bone has a retrograde blood supply, meaning it is at risk of avascular necrosis if not managed promptly.
10025825
a
Scaphoid fracture
QuestionChoice
This is incorrect. The ulna is not typically fractured when falling on an outstretched hand. It is more likely to be fractured by direct impact or falling on a flexed elbow. It is not characterised by tenderness in the anatomical snuffbox or on axial loading of the thumb.
10025829
e
Ulna fracture
QuestionChoice
This is incorrect. Whilst a distal radius (Colle's) fracture commonly results from falling onto an outstretched hand, it would not explain the tenderness in the anatomical snuffbox or on axial loading of the thumb.
10025828
d
Distal radius fracture
QuestionChoice
This is incorrect. The pisiform bone is too medial to be the bone broken in this question. The anatomical snuffbox occupies the lateral aspect of the hand (remember in anatomical position, the arm is supinated) and therefore tenderness in this area could not be explained by a pisiform fracture.
10025826
b
Pisiform fracture
Concept
Chapter
2693
3865
Scaphoid fractures
Topic
145
Orthopaedics
17563
A 22 year old female presents to A&E with a painful, swollen wrist and hand. She was out riding her bike earlier that day when she slipped and fell to the floor on an outstretched left hand. On examination, she has marked tenderness in the region between the extensor pollicis longus tendon and the extensor pollicis brevis and adductor pollicis longus tendon. She also reports pain upon axial loading of the thumb.

Which of the following is the most likely underlying diagnosis?
a