Fractura De Escafoides Tarsiano Derecho

FRACTURE OF THE RIGHT TARSAL SCAPHOID
Bilbao, May 14, 2007

MEDICAL HISTORY:
A 42-year-old patient, with no significant personal history, who comes to the consultation for evaluation of pain and functional limitation in the right foot after trauma during a concert.

PHYSICAL EXAMINATION
No deformity. No hematoma. Slight swelling in the dorsal region of the right foot with intense pain on palpation at the astragaloscaphoid joint. Stable ankle. Conserved mobility. Conserved painless toe mobility. Conserved strength. No alterations in sensitivity. Distal pulses present.

FOR CLINICAL USE
Computed axial tomography of the right ankle: complex fracture of the right tarsal scaphoid without displacement, impaction, or angulation of the fragments, nor ablation of the internal tubercle.

DIAGNOSIS
(this is the moment where medicine reaches the peak of its professional work):
Fracture of the right tarsal scaphoid (5)

Treatment:

1. In acute phase: leg elevated, non-steroidal anti-inflammatory drugs orally, and ice pack.
2. Will walk with the help of crutches.
3. Progressive partial weight-bearing.
4. Ibuprofen 600 mg orally every 8 hours until symptomatic relief.
5. Heparin IBOR 3500 units subcutaneously every 24 hours until starting weight-bearing.
6. Supervised physiotherapy in a specialized center.
7. Evolutionary monitoring and review in 6 to 8 weeks.