--You should perform a careful orthopaedic and neurological exam. Given the patient's age and history of a prior fracture she is likely osteoporotic and prone to fracture. Your skeletal exam should include an evaluation of her other joints to preclude other fractures. Also, you should evaluate the reasons for the patient's fall.

--You should obtain X-rays of the wrist and forearm.

--If this patient only had scaphoid tenderness and a normal X-ray, then the patient would require thumb spica splinting and proper orthopaedic follow-up for a suspected diagnosis of occult scaphoid fracture. These fractures may appear later as callus formation on the X-ray or as remodelling on bone scan.