Scapholunate dissociation: Difference between revisions
| Line 32: | Line 32: | ||
*[[Radial gutter splint]] or [[forearm volar splint]] | *[[Radial gutter splint]] or [[forearm volar splint]] | ||
*Ortho referral | *Ortho referral | ||
==Disposition== | |||
*Generally outpatient followup | |||
==Source== | ==Source== | ||
[[Category:Ortho]] | [[Category:Ortho]] | ||
Revision as of 04:05, 18 February 2015
Background
- Caused by rupture of scapholunate ligament
- Most commonly injured ligament of the wrist
- Injury most commonly occurs from FOOSH
Clinical Features
- Pain/swelling on radial side of wrist
- "Clicking" sensation with wrist movement
Diagnosis
- Imaging
- A grip compression view or wrist in ulnar deviation may be necessary in addition to PA/lateral views
- Any of the following signs may be seen:
- Widening of the scapholunate joint space >3mm
- Know as Terry-Thomas sign (or David Letterman sign)
- Rotary subluxation of the scaphoid
- Lateral view: Scapholunate angle >60 degrees
- PA view: Cortical ring sign (circular cortex of the bone is more prominent)
- Dorsal intercalated segment instability
- Dorsal angulation of lunate relative to radius resulting in capitolunate angle > 20°
- Seen as loss of the normal collinear arrangement of the capitate, lunate, and radius
- Widening of the scapholunate joint space >3mm
Differential Diagnosis
Carpal Dislocations
Carpal fractures
- Scaphoid fracture
- Lunate fracture
- Triquetrum fracture
- Pisiform fracture
- Trapezium fracture
- Trapezoid fracture
- Capitate fracture
- Hamate fracture
Treatment
- Radial gutter splint or forearm volar splint
- Ortho referral
Disposition
- Generally outpatient followup