American Board of Surgical Assistants (ABSA) Orthopedic Practice Test

What injury is commonly associated with a fall onto the outstretched arm?

1. Intercondylar fracture

2. Humeral shaft fracture

3. Elbow dislocation

4. Scaphoid fracture

The correct answer is: Scaphoid fracture

A fall onto an outstretched arm typically leads to an injury where the wrist absorbs the impact, making the scaphoid bone particularly vulnerable. The scaphoid is one of the carpal bones located in the wrist and is situated at the base of the thumb. During a fall, the force transmitted through the wrist can cause a fracture in the scaphoid, often referred to as a "wrist fracture." This type of injury is significant due to its potential complications, including nonunion and avascular necrosis, as the scaphoid has a limited blood supply. Clinical presentations usually include pain in the wrist, particularly in the anatomical snuffbox area, swelling, and wrist movement limitations. Other injuries mentioned have different mechanisms and are less commonly associated with falls on an outstretched arm. Intercondylar fractures typically occur from direct impact to the elbow, humeral shaft fractures can arise from high-energy trauma, and elbow dislocations commonly result from direct trauma to the elbow rather than a fall onto the arm. This differentiation highlights why a scaphoid fracture is the most closely connected injury to this specific scenario.