Scapholunate dissociation: Difference between revisions
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Silas Chiu (talk | contribs) (changed xray views to improve dx) |
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==Diagnosis== | ==Diagnosis== | ||
*Imaging | *Imaging | ||
**A grip compression view or | **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: | **Any of the following signs may be seen: | ||
***Widening of the scapholunate joint space >3mm | ***Widening of the scapholunate joint space >3mm | ||
| Line 17: | Line 17: | ||
***Dorsal intercalated segment instability | ***Dorsal intercalated segment instability | ||
****Dorsal angulation of lunate relative to radius resulting in capitolunate angle > 20° | ****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 | ****Seen as loss of the normal collinear arrangement of the capitate, lunate, and radius | ||
==Treatment== | ==Treatment== | ||
Revision as of 22:03, 9 June 2014
Background
- 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
- 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
Treatment
- Radial gutter splint or short arm volar posterior mold
- Ortho referral
Images
- Black arrow: Scapholunate joint space widening
- White arrow: Cortical ring sign
- Dorsal intercalated segment instability
Source
- Tintinalli