What is the most appropriate action for suspected scaphoid fracture?

• A. Application of a sling
• B. Immediate surgical intervention
• C. Immobilize in a thumb spica splint
• D. Referral for physical therapy

Answer: (C)

The most appropriate action for a suspected scaphoid fracture is to immobilize the wrist in a thumb spica splint. This splint is specifically designed to immobilize the thumb and wrist while allowing for stability of the scaphoid bone, which is critical in minimizing movement and preventing further injury. The scaphoid bone often has a limited blood supply, making it particularly susceptible to complications such as non-union if not adequately stabilized.

Prompt immobilization helps manage pain and supports the healing process. In cases where a scaphoid fracture is suspected, especially with tenderness in the anatomical snuffbox or pain with thumb movement, using a thumb spica spint facilitates early management while awaiting further imaging or evaluation, such as X-rays.

Surgical intervention may eventually be necessary if an instability or non-union is confirmed, but immediate surgery is not typically the first line for suspected fractures. Similarly, immobilizing the wrist in a sling may provide some comfort but does not provide the targeted support required for a scaphoid fracture. Referral for physical therapy would be appropriate after the fracture has healed, but it is not the immediate step in management for a suspected acute fracture.