Tenderness in the anatomic snuffbox on examination most strongly suggests fracture of which carpal bone?

Tenderness in the anatomic snuffbox on examination most strongly suggests fracture of which carpal bone?

• A. Lunate
• B. Capitate
• C. Scaphoid
• D. Hamate

Answer: (C)

Tenderness in the anatomic snuffbox most strongly points to a fracture of the scaphoid because this carpal bone lies right within that hollow behind the thumb. The snuffbox is formed by the tendons of the extensor pollicis longus on one side and the extensor pollicis brevis plus abductor pollicis longus on the other, so an injury to the scaphoid from a fall on an outstretched hand typically produces focal pain in that area. Clinically, this is the classic sign of a scaphoid fracture, and because early X-rays can be falsely negative, a high index of suspicion is needed: immobilize with a thumb-spica splint and pursue advanced imaging if needed (MRI or CT) to confirm. Other carpal bones like the lunate, capitate, or hamate are not situated in the snuffbox, so tenderness there is less indicative of fractures of those bones and would prompt evaluation for different injuries or locations.

Tenderness in the anatomic snuffbox most strongly points to a fracture of the scaphoid because this carpal bone lies right within that hollow behind the thumb. The snuffbox is formed by the tendons of the extensor pollicis longus on one side and the extensor pollicis brevis plus abductor pollicis longus on the other, so an injury to the scaphoid from a fall on an outstretched hand typically produces focal pain in that area. Clinically, this is the classic sign of a scaphoid fracture, and because early X-rays can be falsely negative, a high index of suspicion is needed: immobilize with a thumb-spica splint and pursue advanced imaging if needed (MRI or CT) to confirm.

Other carpal bones like the lunate, capitate, or hamate are not situated in the snuffbox, so tenderness there is less indicative of fractures of those bones and would prompt evaluation for different injuries or locations.