Orthopaedics
Scaphoid Fracture
FOOSH mechanism; high suspicion = empirical immobilisation; MRI for occult fracture; AVN risk in waist + proximal pole.
Source: BOA; BSSH
Step 1 of ~2
info
Recognise
Fall on outstretched hand (FOOSH); pain + swelling in radial wrist / anatomical snuffbox.
Key examination findings (high suspicion):
• Anatomical snuffbox tenderness.
• Tenderness over scaphoid tubercle (volar).
• Pain on axial compression of thumb.
• Pain on resisted pronation.
XR: scaphoid views (PA, oblique, lateral, ulnar deviation) — but normal XR does NOT exclude fracture (10–20% missed initially).
If clinical suspicion + normal XR: empirical immobilisation in scaphoid cast / thumb spica + repeat XR at 10–14 days OR MRI within 7 days (more accurate, fewer missed days off work).
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Palivizumab · RSV Prophylaxis — Monthly Monoclonal Antibody (High-Risk Infants)
- Hydroxocobalamin (High-Dose — Cyanide Antidote) · Cyanide Antidote (Vitamin B12 Precursor at High Dose)
- Thiamine (IV/IM — Pabrinex) · Vitamin B1 (Thiamine) — deficiency treatment / Wernicke's encephalopathy prevention
- Calcium chloride · IV calcium salt (high elemental calcium)
- Thiamine (Vitamin B1) · Vitamin B1 Supplement
- Vitamin B substances with ascorbic acid · High-potency parenteral B + C vitamins
Pathways
- Hip Fracture Pathway · NICE CG124; BPT
- Cauda Equina Syndrome · Society of British Neurological Surgeons; BOA — Best Practice
- Knee Soft Tissue Injury (ACL / MCL / Meniscus) · BOA; Royal College of Surgeons
- Shoulder Dislocation · BOA; RCEM
- Pelvic Fracture · BOA; ATLS; NICE NG39
- Achilles Tendon Rupture · BOA
Decision support only. Always apply local guidelines and clinical judgement.