The anatomical snuffbox

Question 1

The anatomical snuffbox?

Answer 1

(Also known as the radial fossa),

• Is a triangular depression found on the lateral aspect of the dorsum of the hand. It is located at the level of the carpal bones, and best seen when the thumb is abducted.
• In the past, this depression was used to hold snuff (ground tobacco) before inhaling via the nose – hence it was given the name ‘snuffbox’.

Question 2

As the snuffbox is triangularly shaped, it has three borders, a floor, and a roof:

Answer 2

• Ulnar (medial) border: Tendon of the extensor pollicis longus.
• Radial (lateral) border: Tendons of the abductor pollicis longus and extensor pollicis brevis.
• Proximal border: Styloid process of the radius.
• Floor: Carpal bones; scaphoid and trapezium.
• Roof: Skin.

Question 3

Answer 3

The main contents of the anatomical snuffbox are:

• the radial artery, a branch of the radial nerve,
• and the cephalic vein.

Question 4

Clinical Relevance: Fractures of the Scaphoid?

Answer 4

• In the anatomical snuffbox, the scaphoid and the radius articulate to form part of the wrist joint. In the event of a blow to the wrist (e.g falling on an outstretched hand), the scaphoid takes most of the force.
• If localised pain is reported in the anatomical snuffbox, a fracture of the scaphoid is the most likely cause.
• The scaphoid has a unique blood supply, which runs distal to proximal. A fracture of the scaphoid can disrupt the blood supply to
• the proximal portion – this is an emergency. Failure to revascularise the scaphoid can lead to avascular necrosis, and future arthritis for the patient.