A patient describes a fall on the outstretched hand during sports activities. Multiple radiographic views show no distinct fracture. He is tender to palpation in the anatomic snuffbox. The most suitable method of management is:

B. Diagnose suspected scaphoid fracture and apply a short-arm cast to include the thumb.

DISCUSSION: If the patient sustained a fall on the outstretched hand and is tender to palpation in the anatomic snuffbox, fracture of the scaphoid should be suspected. Neither an elastic bandage nor a canvas wrist splint provides adequate immobilization for the scaphoid. A short-arm cast to include the thumb is the most appropriate treatment. Salicylates and continued activity would not treat scaphoid fracture. If no fracture is noted initially, the cast is applied and films are taken at 10 days to 2 weeks since nondisplaced scaphoid fractures are often more easily visualized at that time.