رجل عمره ٣٥ سنة سقط على يده الممدودة، ويشتكي ألماً في قاعدة الإبهام عند الضغط على المنطقة بين أوتار الإبهام (صندوق النشوق التشريحي). الأشعة الأولى طبيعية. ما الإجراء المناسب؟

A 35-year-old fell on an outstretched hand and has pain at the base of the thumb on pressing the anatomical snuffbox. The first X-ray is normal. What is appropriate?

1. Splint as a scaphoid fracture and re-image
2. Vigorous wrist exercises from today
3. Reassure and discharge without immobilisation
4. Massage the wrist three times daily

Answer: A) Splint as a scaphoid fracture and re-image. Scaphoid fractures may not show on initial X-ray and missed ones risk avascular necrosis; immobilise and re-image or perform MRI.