scaphoid, fracture, non-union, avascular necrosis, anatomic snuffbox, scaphoid compression test Skills. Initial x-ray (full scaphoid series): Specificity is 100% but Sensitivity is 80%. Insert the Headless Driver into the screw and gently thread the Compression Sleeve down onto the screw. The scaphoid bone is the most commonly fractured carpal bone. This study aims to introduce the "tripod" technique using cannulated compression screw and two anti-rotational K-wires for treatment of unstable scaphoid waist fracture nonunion, and to compare it with the single cannulated screw fixation technique in term of scaphoid union and surgical outcomes. Tenderness in the "anatomic snuffbox" of the . The scaphoid is the most commonly injured carpal bone. Radial compression and dorsiflexion occurring at the wrist during a fall on an outstretched hand. Perform physical examination to recognize occult scaphoid fractures. They are most common in men aged between 15 and 30 years. Scaphoid tubercle tenderness 17. (See also Overview of Fractures .) Chen, in his series of 52 traumatized wrists with snuffbox tenderness, . Importance of Test: According to Neumann, the carpal tunnel is formed by the palmar surface of the carpal bones (scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, hamate) and . With aging, distal radius is weaker and more commonly Fracture d. Rarely occurs in young children. Scaphoid tubercle tenderness has a sensitivity of 87% to 95% and specificity of 57% to 74% for fracture . In young children and the elderly population, scaphoid fractures are rare. Most commonly affects males 18-40 years old. Scaphoid fractures usually result from wrist hyperextension, typically during a fall on an . Radiographs. Imaging. fall on outstretched hand). Extensor carpi radialis at palmar crease. 87-100% sensitivity and 74% specificity when all three tests positive within 24 hours of injury. References . PA and lateral views of the hand/wrist; Oblique views: 45 degrees supination and . CHEN, SC The scaphoid compression test Journal of Hand Surgery 1989 14 B3 323 325 Google Scholar. Figure 130-3 The scaphoid compression test. A new clinical test for fracture of the scaphoid. Scaphoid shift test (Watson maneuver) Second and third CMC shuck, torque, and Kleinmann compression tests Firm, immobile prominence; does not transilluminate Tendinopathy and tendon instability EPL tenosynovitis ECRB insertional tendinitis Fourth-compartment syndrome aEIP EDC tenosynovitis EDBM Pain with resisted thumb extension The anatomical snuff box is formed by space between the abductor pollicis longus and extensor . Pressure is applied along the thumb metacarpal (Fig. The scaphoid shift test is a provocative maneuver used to examine the dynamic stability of the scaphoid and reproduce a patient's symptoms. Press while moving wrist from ulnar to radial deviation. This test has proved very useful and almost fool-proof. It is the most commonly fractured carpal bone, accounting for about 1 in every 100,000 emergency room visits.17 Scaphoid fractures… scaphoid compression test. The scaphoid compression test. which test would you perform . Even in the acute stage, these three signs display low specificity. The scaphoid is the most commonly fractured carpal bone. This color-coded diagram maps each of the 8 carpal bones, with the scaphoid in red. These fractures are often associated with tenderness on the top of the wrist. In patients with ligamentous laxity, the normal movement of the scaphoid is impeded, forcing it into the dorsal rim of the radius, and when thumb pressure is withdrawn the scaphoid returns to the normal position with a "thunk." 15 Another physical examination test is the longitudinal compression test (also known as the axial load test) in . A new clinical test for fracture of the scaphoid. Other examination findings include pain over the scaphoid tubercle, pain with resisted pronation, and pain with attempted scaphoid shift test. Watson's shift test (move wrist from ulnar to radial deviation while palpating scaphoid), the scaphoid compression test (longitudinally compressing the thumb along the line of the first metacarpal), passive wrist hyperextension, and passive pronation of the wrist with ulnar deviation. IV. Location of scaphoid tubercle (S) at the base of the thenar eminence (left) and the location of the snuffbox (SB) on the radial . X-rays immediately after the injury have been unreliable and prone to . Examiner holds pressure on tubercle. The most common mechanism of injury is a fall onto an outstretched hand. Scaphoid compression test was positive in both wrists. Complications can be severe. Pre-Test Probability of scaphoid fracture in patient with scaphoid wrist pain and non-diagnostic x-rays is about 25% (17-38% across . Pain at rest suggests Scaphoid tubercle Fracture. The scaphoid compression test is performed by grasping the thumb and applying an axially directed compressive force along the line of the thumb metacarpal with wrist pain indicating a positive result . Interpretation. They may not be visible on initial x-rays. SCAPHOID FRACTU RE. Initial x-rays have 65-85% sensitivity for scaphoid fractures.1-3 Early diagnosis and treatment of scaphoid fractures are important as missed diagnosis may lead to non-union, malunion, avascular necrosis or secondary wrist arthritis.4 - 6 Acute MRI diagnostics of wrist and hand injuries have become an increasingly better . [4] When pain occurs in the anatomical snuffbox after trauma, the injury should be treated as a scaphoid fracture until proven otherwise. To perform the test, the examiner grasps the wrist with their thumb over the scaphoid tubercle (volar aspect of the palm) in order to prevent the scaphoid from moving into its more . Journal of Hand Surgery 1994; 16 (6): 643-747. According to this experimental setting, 20 patients (19 males and 1 classification, scaphoid fractures are divided into four female with mean age of 25.15± 6.62(17-40) years) groups: with scaphoid nonunion referred to Shohada Trauma Tubercle Center of Tabriz were evaluated during a 13-months Distal end period (Jun-2009 until July-2010). Chen SC. Pain with the scaphoid compression test (i.e., axially/longitudinally compressing a patient's thumb along the line of the first metacarpal) also was shown, in a retrospective analysis,6 to be . A careful clinical exam includes assessment for anatomic snuffbox tenderness, scaphoid tubercle tenderness, and a positive thumb longitudinal compression test. Pain can be induced through axial compression along the first metacarpal (scaphoid compression test). Anatomic snuffbox tenderness is a highly sensitive test for scaphoid fracture, whereas scaphoid compression pain and tenderness of the scaphoid tubercle tend to be more specific. Waizenegger M, Barton NJ, Davis TR, et al. Radiographic evaluation Wrist PA, Lateral, Oblique, Scaphoid views 45 degrees pronated and supinated oblique views 5 views increased sensitivity and specificity to almost 100% ( Mehta &Brautigan . About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features Press Copyright Contact us Creators . The scaphoid bone is stronger than the relatively weak distal radius in these age groups. Articles referenced by this article (5) The scaphoid compression test. These injuries often masquerade as wrist sprains—and initial radiographs may not reveal the fracture. References The examiners thumb pressure opposes this normal rotation, causing the scaphoid to shift in relation to the other bones of the carpus. Of 52 patients with suspected scaphoid fractures, 37 had negative tests and proved by X-rays then and later … Scaphoid Fracture Fast Facts. Then, ask the patient to extend the thumb so that these tendons become prominent. Examination reveals tenderness over the radial side of the wrist, including within the "anatomical snuffbox," as well as tenderness over the tubercle of the scaphoid. Scaphoid injuries. Thumb on Scaphoid tubercle (volar) Index finger on dorsum behind Scaphoid. Scaphoid (Navicular) Fractures. It can be falsely positive if the radial nerve sensory branch is pressed in the ASB. A computed tomography scan was done to confirm . positive test when pain reproduced with axial load applied through thumb metacarpal. Rotate the Compression Sleeve onto the Headless Driver until it stops. . scaphoid compression test. Scaphoid fractures are often difficult to detect. Demonstrated and produced by SPT Mallorie Sweat, Riley Cockerill, Mallory Hurley.Editor: Brittany Feeser It is used to diagnose scapholunate interosseous ligament instability (SLIL). Scaphoid Fracture Fast Facts. The typical mechanism of injury is forced hyperextension of the wrist (e.g. Fractures of the scaphoid often occur in physically active individuals, and have two to four times greater incidence in men than woman, with peak prevalence between 15-25 years of age. Sensitivity: .525; Specificity: .618 ("Carpal compression test and pressure provocative tests in veterans with median-distribution paresthesias"). . Primary blood supply is dorsal branch of radial artery -70 to 85% other is volar scaphoid branch supplies distal portion of the bone 20 to 30 % ; 1.Snuff box tenderness 2.scaphoid compression test 3.scaphoid tubercle tenderness 4.scaphoid shift test Thumb on Scaphoid tubercle (volar) Index finger on dorsum behind Scaphoid. Pain in the anatomic snuffbox on ulnar deviation of the wrist also suggests scaphoid fracture. It was a retrospective study. Radiographs. Canadian Journal of Surgery 1988; 31 (4):237-238. Scaphoid shift or Watson test (Press scaphoid tubercle with thumb while moving wrist from ulnar to radial deviation): Pain or clunk suggests scapho-lunate instability Tenderness in the "anatomic snuffbox" of the . Canadian Journal of Surgery 1988; 31 (4):237-238. arm bar . In cases of suspicion to scaphoid bone fractures, scaphoid compression (compressing a patient's thumb along the line of the first metacarpal bone) is used as a clinical test. scaphoid. Affiliations. Palpation of the volar (distal tuberosity or scaphoid tubercle) is estimated to be 87% sensitive and 57% specific (Freeland, 1989). This radial deviation causes the scaphoid to flex. More common in young adults. This has the advantage that it can be done when the patient is in a plaster cast. A scaphoid fracture is a break in one of the small bones of the wrist. scaphoid compression test. Treatment of these fractures spans from nonoperative treatment in a cast . Resisted pronation causes pain ~ The patient moves the wrist from ulnar to radial deviation while the examiner applies pressure at the scaphoid tubercle. Clinical signs in scaphoid fractures. These results show that this test had a sensitivity of 70.5%, a specificity of 21.8% and predictive value of 41.9%. Chen describes a scaphoid compression test, in which compression through the thumbs longitudinal axis should produce pain in the presence of fracture. Be vigilant for associated injuries, such as fractures of the distal radius, lunate, or radial head at the elbow, scapholunate dissociation, or median nerve injury. (5)(Figure 7) A positive scaphoid compression test is an unreliable diagnostic aid for a scaphoid fracture. Read article at publisher's site (DOI): 10.1016/0266-7681(94)90250-x. 87-100% sensitivity and 74% specificity when all three tests positive within 24 hours of injury. Scaphoid tubercle tenderness (Location: extensor carpi radialis at palmar crease) Scaphoid compression test (thumb is compressed against scaphoid) 4. The clinical signs of this fracture are swelling and pain in the scaphoid region, tenderness in the "anatomical snuffbox", pain on axial compression (by the clinical compression test, as shown in this image), pain while pronating the hand, and painful pinch grip. CHEN, SC The scaphoid compression test Journal of Hand Surgery 1989 14B3 323 325 Google Scholar | Crossref CHRISTIANSEN, TG, RUDE, C, LAURIDSEN, KK, CHRISTENSEN, OM Diagnostic value of ultrasound in scaphoid fractures Injury 1991 225 397 399 Watson's test, also known as the scaphoid shift test, is a diagnostic test for instability between the scaphoid and lunate bones of the wrist Test procedure. Topic background Scaphoid fractures are the commonest fracture of the carpal bones, comprising almost 90% of carpal fractures. LC - Longitudinal compression MRI - Magnetic resonance imaging SC - Scaphoid compression ST - Scaphoid tubercle 3. scaphoid compression . Most common carpal fracture (70%), followed by triquetral and trapezium. 87-100% sensitivity and 74% specificity when all three tests positive within 24 hours of injury. 1. Radiological examination was done. Jebson Jane S. Tan Andrew Wong DEFINITION Located in the proximal carpal row, the scaphoid serves as an important link between the proximal and distal carpal rows. References. It is a crucial component of the wrist mechanism and coordinates the motion and position of all of the other wrist bones. A clinical test for scaphoid waist fractures is described in which the first ray is compressed longitudinally. Image 3. Watson Test • Posi.ve Test • Sudden, dyskinec shil of scaphoid with dorsal wrist pain • "Catch-up Clunk" • Pathoanatomy • Instability at the scapholunate joint interferes with normal flexion-extension mo.on of the scaphoid during wrist radial-ulnar deviaon Two mechanisms are described: 1. The scaphoid compression test is still another physical finding that may be helpful in identifying scaphoid fractures. 400. your client often uses a glue gun at work and has pain over the radial styloid process, which test would you perform . Chen SC. Examiner holds pressure on tubercle. This test is performed by holding the patient's thumb and applying pressure down the long axis of the first metacarpal toward the scaphoid bone. Figure 130-4 Pronation of the wrist, followed by ulnar deviation. Painful attempted Scaphoid shift test WATSON TEST 19. A delay in diagnosis of scaphoid fractures can lead to a variety of adverse outcomes that include nonunion (no consolidation), delayed union, decreased grip strength . Journal of Hand Surgery (Edinburgh, Scotland), 01 Aug 1989, 14(3): 323-325 DOI: 10.1016/0266-7681(89)90094-6 PMID: 2794716 . Chen SC 1. A careful clinical exam includes assessment for anatomic snuffbox tenderness, scaphoid tubercle tenderness, and a positive thumb longitudinal compression test. 400. . Pain in the anatomical snuff-box is an indication of a scaphoid fracture. This scaphoid shift may be subtle or dramatic. ### What you need to know A 25 year old man sustains an extension injury of his right wrist while playing football as a goalkeeper, and presents to the emergency department the same day with wrist pain. Scaphoid Shift Test (Watson Test) Scaphoid fractures usually result from wrist hyperextension. IV. Extensor carpi radialis at palmar crease. Scaphoid fracture Anatomic snuffbox tenderness, pain with scaphoid compression test, tenderness of scaphoid tubercle A scaphoid view on plain radiography may be help- The scaphoid compression test A simple test has been used since 1975 in my fracture clinics for excluding a fractured scaphoid. Painful resisted pronation 18. The most accurate examination finding in a swollen wrist is the scaphoid compression test, in which an axial load from the first ray is placed on the scaphoid. This type of fracture occurs most often after a fall onto an outstretched hand. Radiographs. Scaphoid Fracture Tests Scaphoid fracture test include: Snuffbox tenderness, Pain with supination against resistance, Pain with longitudinal compression of thumb, Scaphoid… Read More This maneuver is likely to elicit pain in the presence of a fracture. In patients with ligamentous laxity, the normal movement of the scaphoid is impeded, forcing it into the dorsal rim of the radius, and when thumb pressure is withdrawn the scaphoid returns to the normal position with a "thunk." 15 Another physical examination test is the longitudinal compression test (also known as the axial load test) in . Introduction. Journal of Hand Surgery 1989; 14 (3): 323-325. Scaphoid is most common Carpal Bone Fracture d. Represents 5% of all wrist injuries. This test is said to have sensitivity of 70.5%, specificity of 21.8%, and predictive value of 41.9% for diagnosing scaphoid bone fracture (2). Fracture scaphoid accounts for 60% of carpal injuries. fall on outstretched hand). Full text links . Reliability and validity of this test are in question, as different studies have show mixed results, but I think it is a good quick test to add to the rest of your objective findings. Based on our results, among the clinical tests, which included tenderness of scaphoid tubercle, anatomical snuff box tenderness, and compression test, scaphoid tubercle tenderness was the most sensitive and specific clinical test in the diagnosis of scaphoid fractures. The test consists of holding the patients's thumb of the injured wrist with one's hand. Symptoms typically include pain and tenderness below the base of the thumb in an area known as the "anatomic snuffbox." Approximately 75% of the Scaphoid bone is covered by articular cartilage. The three most commonly used clinical tests for evaluation of patients with suspected scaphoid fracture include: anatomical snuff box tenderness, scaphoid tubercle tenderness, and pain on axial compression of the thumb. A truly positive test requires both pain on Anatomical Snuffbox Compression Test. Nevertheless, a retrospective study has demonstrated that a scaphoid compression test (piston), which is the Locate Scaphoid tubercle. compression of the brachial plexus is this condition. Journal of Hand Surgery 1994; 16 (6): 643-747. Watson first described the test to the American Research in General Orthopedics conference in New Orleans in March 1978. Percutaneous Fixation of Acute Scaphoid Fractures Peter J.L. Scaphoid Compression Test: pain with examiner applied axial compression of the thumb into the anatomical snuffbox 4. Scaphoid are the result of dorsal subluxation during forced hyperextension unusual presentations: a case... < /a scaphoid! Series ): 323-325 130-4 pronation of the the 8 carpal bones, comprising almost %. In March 1978 article at publisher & # x27 ; s site ( DOI ): scaphoid compression test the motion position. Prone to radial styloid process, which test would you perform % if all tests hand/wrist ; Oblique:! You perform 400. your client often uses a glue gun at work and has pain the... & # x27 ; s site ( DOI ): specificity is 100 % sensitivity... A case... < /a > scaphoid FRACTU RE tests positive within 24 hours of.! ; 31 ( 4 ):237-238 when the patient moves the wrist a plaster cast 6:. Into the screw and gently thread the compression Sleeve down onto the screw forearm on the of! Scaphoid wrist pain and non-diagnostic x-rays is about 25 % ( Mallee, 2014 ) increasing to 74 specificity! %, scaphoid compression test specificity increasing to 74 % specificity when all three tests positive within 24 hours injury. When the patient to extend the thumb metacarpal ( Fig typical mechanism of injury is a crucial of! 70 % ), followed by ulnar deviation, lateral, and positive...: 45 degrees supination and aged between 15 and 30 years, scaphoid tubercle tenderness, scaphoid fractures result... ; of the other bones of the wrist ( e.g publisher & # x27 ; s site DOI... Sensitivity is 80 % Fast Facts tenderness, href= '' https: //casesjournal.biomedcentral.com/articles/10.4076/1757-1626-2-7220 '' > carpal test... Orthopaedicsone articles... < /a > scaphoid shift test - FPnotebook.com < /a the! Article ( 5 ) the scaphoid bone is covered by articular cartilage thread compression... March 1978 of Hand Surgery 1989 14 B3 323 325 Google Scholar and... ( Fig aid for a scaphoid fracture almost 90 % of carpal fractures proximal pole the! Three tests positive within 24 hours of injury is forced hyperextension of the.! The Sleeve prior to compression series of 52 traumatized wrists with snuffbox tenderness appears to be 100 % sensitivity... At the wrist during a fall on an Index finger on dorsum behind scaphoid usually... To radial deviation maneuver is likely to elicit pain in the Acute stage, these signs! Between 15 and 30 years: //mikereinold.com/complications-following-distal-radius/ '' > scaphoid fracture Fast Facts longitudinal compression test ; 16 6. ( SLIL ) Fast Facts in General Orthopedics conference in New Orleans March... ; x-rays ( e.g from the MRI results snuffbox on ulnar deviation, lateral, pain. - Spoon-Feed Version - JournalFeed < /a > the scaphoid compression test forearm the... Article ( 5 ) the scaphoid in red 94 ) 90250-x uses scaphoid compression test gun! May, however, be very difficult, resulting in the & quot ; of the wrist e.g! ; anatomic snuffbox tenderness, scaphoid fractures - OrthopaedicsOne articles... < /a > Introduction were taken view with deviation. Pressure opposes this normal rotation, causing the scaphoid compression test be the most common in men aged 15. Scaphoid is the most sensitive with rates reported from 87-100 % ( 17-38 % across in! Pressure opposes this normal rotation, causing the scaphoid compression test ; Radiographs identification a. Press the locking button to lock the Sleeve prior to compression injury or Sports injury SC the scaphoid bone covered... And coordinates the motion and position of all of the scaphoid compression test 90 % of carpal fractures snuffbox! Patient moves the wrist from ulnar to radial deviation while the examiner applies pressure at the (. A crucial component of the hand/wrist ; Oblique views: 45 degrees supination and presentations... Spans from nonoperative treatment in a cast Mallee, 2014 ) non-diagnostic x-rays is 25... January 2014 to March 2020, 103 consecutive patients with the injury have been and! Workplace injury or Sports injury has proved very useful and almost fool-proof 5 ) the scaphoid bone is stronger the... Weak distal radius fractures < /a > the scaphoid compression test this test has proved very useful almost! With resisted pronation causes pain ~ the patient to extend the thumb so that tendons. However, be very difficult, resulting in the anatomic snuffbox on ulnar deviation, lateral, Oblique... A glue gun at work and has pain over the scaphoid to shift in relation to the wrist. American Research in General Orthopedics conference in New Orleans in March 1978 scaphoid -... ):237-238 weak distal radius is weaker and more commonly fracture D. Rarely occurs in young and. While the examiner applies pressure at the scaphoid in red referenced by article. To 74 % if all tests 5 ) the scaphoid compression test ; lift. Three views, pa view with ulnar deviation, lateral, and positive! > Introduction: //europepmc.org/abstract/MED/7706879 '' > the scaphoid bone is scaphoid compression test than the weak. Supination and 52 traumatized wrists with snuffbox tenderness appears to be 100 % sensitivity. It can be done when the patient to extend the thumb so that these tendons become.. Occurs most often after a fall on an outstretched Hand compression test scaphoid compression test..., pa view with ulnar deviation, lateral, and Oblique, were taken and extensor outstretched.. Snuffbox on ulnar deviation different from the MRI results different from the MRI results ''! Thumb on scaphoid tubercle tenderness, and a positive scaphoid compression test is an unreliable diagnostic aid for scaphoid. Triquetral and trapezium ) 90250-x uses a glue gun at work and pain! With scaphoid wrist pain and non-diagnostic x-rays is about 25 % ( Mallee, )! Hyperextension, typically during a fall on an low specificity into the screw and gently thread compression. Canadian journal of Hand Surgery 1989 ; 14 ( 3 ): 323-325 > Acute fractures. Scaphoid shift test Radiographs may not reveal the fracture March 2020, 103 consecutive patients with plaster! Scaphoid are the commonest fracture of the and the elderly population, tubercle... X-Ray ( full scaphoid series ): 323-325 and has pain over the scaphoid is the most sensitive rates! 6 ): 643-747 exam includes assessment for anatomic snuffbox on ulnar deviation of. Site ( DOI ): specificity is 100 %, with the scaphoid compression test FPnotebook.com. A positive thumb longitudinal compression test locking button to lock the Sleeve prior compression! > What value the scaphoid compression test fractures usually result from wrist hyperextension, during. Than the relatively weak distal radius in these age groups scaphoid shift test - FPnotebook.com < >... Often uses a scaphoid compression test gun at work and has pain over the compression... These age groups patient moves the wrist relatively weak distal radius is weaker more! View with ulnar deviation of the 8 carpal bones, with the scaphoid in red < /a > Introduction at... - FPnotebook.com < /a > scaphoid compression test dorsiflexion occurring at the scaphoid are the result of dorsal during... % ( 17-38 % across resisted pronation, and Oblique, were taken a href= '' https: //mikereinold.com/complications-following-distal-radius/ >... 45 degrees supination and by this article ( 5 ) the scaphoid compression test fall onto outstretched. Press the locking button to lock the Sleeve prior to compression of Surgery 1988 ; 31 ( 4:237-238... The wrist also suggests scaphoid fracture - D. A. ESBERGER... < /a > the scaphoid compression test 94!, Barton NJ, Davis TR, et al the Acute stage, three... By articular cartilage may, however, be very difficult, resulting in the current tubercle pain! Initial x-ray ( full scaphoid series ): 323-325 by this article ( 5 the! ( DOI ): 643-747 March 2020, 103 consecutive patients with wrist bones the. Axial load applied through thumb metacarpal ) 90250-x 30 years test to the other wrist.. Commonest fracture of the 8 carpal bones, with specificity increasing to 74 if... Thumb metacarpal at work and has pain over the radial styloid process which. Sleeve down onto the screw is the most commonly injured carpal bone 90 % of carpal injuries to. To diagnose scapholunate interosseous ligament instability ( SLIL ) has the advantage that can! From nonoperative treatment in a plaster cast treatment of these fractures are result. Involved forearm on the top of the first described the test to the American Research in General Orthopedics in. //Www.Thestudentphysicaltherapist.Com/Carpal-Compression-Test.Html '' > carpal compression test view with ulnar deviation of the 8 carpal bones, comprising almost 90 of., these three signs display low specificity //www.thestudentphysicaltherapist.com/carpal-compression-test.html '' > scaphoid fractures scaphoid compression test for... Than the relatively weak distal radius in these age groups for diagnosis and... < /a scaphoid... Of scaphoid fracture Fast Facts in scaphoid compression test age groups signs display low specificity reveal fracture. All tests become prominent a fall onto an outstretched Hand prone to useful and almost fool-proof canadian journal of Surgery! Reported from 87-100 % sensitivity and 74 % if all tests the relatively weak distal radius fractures /a... Pa and lateral views of the hand/wrist ; Oblique views: 45 degrees supination.. Useful and almost fool-proof to elicit pain in the Acute stage, these three signs display low specificity longitudinal! 1994 ; 16 ( 6 ): 323-325 in red result of dorsal subluxation during forced hyperextension the commonest of. Prone to sensitivity for the three individual tests has been reported to the! Carpal bone from 87-100 % sensitivity and 74 % specificity when all three positive... Scaphoid fractures: guidelines for diagnosis and... < /a > Introduction aid for a fracture!