Anatomical snuff box palpation is used to assess for which injury?

• A. Scaphoid fracture
• B. Lunate dislocation
• C. Bennett's fracture
• D. Hook of hamate fracture

Answer: (A)

Tenderness in the anatomical snuff box points to a scaphoid fracture because the scaphoid sits in the floor of this triangular hollow between the tendons of the thumb. When the scaphoid is fractured, pressing in this area reproduces pain, making snuff box tenderness a highly sensitive sign after a fall on an outstretched hand. Imaging may be normal early on, so recognizing this sign is crucial to avoid missing a fracture; immobilization in a thumb spica cast and follow-up with MRI or CT if needed helps prevent complications like nonunion or avascular necrosis due to the scaphoid’s precarious blood supply.

Lunate dislocation typically presents with more dramatic carpal instability and possible median nerve symptoms rather than focal snuff box tenderness. A Bennett’s fracture involves the base of the first metacarpal at the thumb’s carpometacarpal joint, with pain localized at the thumb base, not the snuff box. Hook of hamate fracture causes ulnar-sided hand pain, often with grip weakness and tenderness at the hypothenar area, not in the snuff box.