Nice guidelines for suspected schaphoid bone fractures

Initial assessment and imaging: For people with suspected scaphoid fractures, NICE recommends a thorough clinical examination followed by consideration of MRI as the first-line imaging modality to improve diagnostic accuracy.

Immobilisation and management: If a scaphoid fracture is suspected clinically but initial X-rays are normal, immobilise the wrist in a thumb spica splint or cast and arrange for further imaging or specialist follow-up.

Follow-up and referral: Ensure definitive imaging reports are available before discharge from the emergency department. Refer to orthopaedics if the diagnosis is uncertain, symptoms persist, or if there is evidence of fracture on imaging.

Patient information: Provide verbal and written information about expected outcomes, self-care, rehabilitation, and when to seek further medical advice.

These recommendations are based on the NICE guideline on non-complex fractures, which includes specific advice on scaphoid fractures emphasizing MRI for first-line imaging after clinical assessment ¹.