Controversies and best practices for acute scaphoid fracture management.

A 24-year-old baker presents to the clinic after slipping on a bag of spilled flour and falling onto an outstretched right hand. She is right-hand dominant and has not been able to whisk or lift pans out of the oven without significant pain in the wrist and thenar eminence since the time of the fall 7 days ago. Radiographs taken in the clinic today are shown in Figure A. Which of the following provides the most compelling reason to pursue open reduction internal fixation (ORIF) of her fracture at this time?