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I suspect not as they were all undisplaced.

	-----Original Message----- 
	From: Accident and Emergency Academic List on behalf of Andy Webster 
	Sent: Tue 22/06/2004 09:49 
	To: [log in to unmask] 
	Cc: 
	Subject: Re: is it a scaphoid fracture?
	
	

	Would those have had any risk of complication if you had just treated
	them in a splint, or even left open to the fresh air!!
	
	Andy Webster
	+44 226750279 (home)
	+44 7989 587971 (mobile)
	
	
	-----Original Message-----
	From: Accident and Emergency Academic List
	[mailto:[log in to unmask]] On Behalf Of Simon Odum
	Sent: 22 June 2004 07:09
	To: [log in to unmask]
	Subject: Re: is it a scaphoid fracture?
	
	I normally explain that I am going to x-ray them, but the fracture may
	not show up on this x-ray, so either way they are leaving with a support
	(POP or futuro depending on x-ray) and they are followed up by our
	physio practitioner at 2 weeks post presentation.
	
	Interestingly (and anecdotally!) we have had 4 or 5 fractured scaphoids
	that were not radiologically evident until 6-8 weeks post injury but
	were followed up due to persistent symptoms and were all treated in POP.
	
	Simon Odum
	
	-----Original Message-----
	From: Accident and Emergency Academic List
	[mailto:[log in to unmask]] On Behalf Of Doc Holiday
	Sent: 21 June 2004 23:29
	To: [log in to unmask]
	Subject: Re: is it a scaphoid fracture?
	
	Adrian wrote:
	
	The majority of patients who have "tenderness" in the snuffbox following
	a
	fall on the outstretched hand DO NOT turn out to have a scaphoid
	fracture. I
	think it's completely wrong then to tell everyone "you have a scaphoid
	fracture" as Doc has described. There are myriad other reasons for
	having
	ASB tenderness; scaphoid fracture is but one, and is much less common
	than a
	simple wrist sprain for example.
	
	---> I was being brief for the sake of clarity... Which is the reason
	for
	the confusion... Don't literally say "it's broken 100% and I will not
	change
	my mind". Merely ACT as if it is FOR THE TIME BEING and give the patient
	the
	clear impression that FOR NOW, it is how you'll treat it.
	
	---> As your (far) greater experience than mine (no sarcasm) will tell,
	when
	one has to appologise for or defend juniors who've made a booboo in this
	case, it's always for NOT treating a fracture as a fracture. Complaints
	from
	patients about treatment of their sprain as a fracture are rare and
	financially un-embarrassing.
	
	So in summary then, if x-rays are negative, tubigrip or the like
	followed by
	A&E review 7-10 days later where many are then discharged. If x-rays are
	positive, simple backslab and refer to orthopod who has an interest in
	operating on these.
	
	--> And where, pray tell, does one still find tubigrip nowadays? And
	why?
	
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