1. A 45-year-old construction worker accidentally fell 20 ft from a scaffolding. He is unable to flex or extend his right wrist due to pain. Examination of the wrist shows a moderate amount of soft-tissue swelling with moderate tenderness along the base of the first metacarpal.
Diagnosis: The radiograph shows an acute, comminuted fracture of the scaphoid bone. The patient was placed in a thumb spica splint and sling. He was instructed to follow up in one to two days with the hand surgeon who was on call, with anticipation of subsequent open reduction and internal fixation.
For more information, see “Construction Worker Falls From Scaffolding.” Clinician Reviews. 2013;23(11):15.