Fractures: suspected scaphoid fracture: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Fractures: suspected scaphoid fracture

Sample item

A young man has snuffbox tenderness after a fall on the outstretched hand, but initial wrist radiographs including scaphoid views are normal. What is the most appropriate management?

APerform urgent open reduction and screw fixationBApply a crepe bandage and mobilise at onceCImmobilise in a thumb spica cast and reassess with repeat radiographs or MRIDDischarge with analgesia since radiographs are normal

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Immobilise in a thumb spica cast and reassess with repeat radiographs or MRI

Early radiographs miss a significant number of scaphoid fractures. Clinical suspicion mandates immobilisation in a thumb spica and repeat imaging at 10 to 14 days, or early MRI, to avoid missed fracture and avascular necrosis.

Option by option

A. Perform urgent open reduction and screw fixation
Surgery is not indicated without a confirmed displaced fracture.
B. Apply a crepe bandage and mobilise at once
A bandage and mobilisation do not protect a possible fracture.
C. Immobilise in a thumb spica cast and reassess with repeat radiographs or MRI (correct)
Correct. Treat as a fracture and re-image later or use MRI.
D. Discharge with analgesia since radiographs are normal
Discharging risks a missed fracture that can go on to nonunion.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Immobilise in a thumb spica cast and reassess with repeat radiographs or MRI. Early radiographs miss a significant number of scaphoid fractures.

Why is "Perform urgent open reduction and screw fixation" not the answer?

Surgery is not indicated without a confirmed displaced fracture.

Why is "Apply a crepe bandage and mobilise at once" not the answer?

A bandage and mobilisation do not protect a possible fracture.

Why is "Discharge with analgesia since radiographs are normal" not the answer?

Discharging risks a missed fracture that can go on to nonunion.

What concept does this question test?

It tests Fractures: suspected scaphoid fracture in Orthopaedics. Clinical suspicion mandates immobilisation in a thumb spica and repeat imaging at 10 to 14 days, or early MRI, to avoid missed fracture and avascular necrosis.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Fractures: suspected scaphoid fracture?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.