An elderly woman with wrist pain near the anatomic snuffbox after a fall; which carpal bone is most likely fractured?

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

Answer: (C)

Pain in the anatomic snuffbox after a fall on an outstretched hand points to a scaphoid fracture. The scaphoid lies at the base of the thumb and marks the border of the snuffbox; when it breaks, tenderness is most notable there. It’s the carpal bone most commonly fractured in FOOSH injuries, and X-rays can be negative initially, so a high index of suspicion often leads to immobilization with a thumb-spica splint and prompt follow-up imaging (MRI or CT) if symptoms persist. The scaphoid’s blood supply travels retrograde from the distal to the proximal pole, which makes proximal-fragment ischemia and nonunion a real concern if diagnosis or treatment is delayed. The other bones listed don’t typically produce snuffbox tenderness as the hallmark finding after a fall, and their injury patterns differ.