II. Mechanism

  1. Fall on Outstretched Hand
  2. Scapholunate interosseous ligament is disrupted resulting in instability

III. Symptoms

  1. Radial aspect Wrist Pain, worse with gripping

IV. Imaging

  1. Wrist XRay
    1. Scaphoid Bone and Lunate Bones separated 3 mm or more (aka Terry Thomas Sign, David Letterman Sign)
  2. Clenched-Fist View
    1. Accentuates widening between the Scaphoid Bone and the Lunate Bone

V. Differential Diagnosis

VI. Associated Conditions

VII. Management

  1. Immobilization in short arm volar splint
  2. Refer to orthopedics or orthopedic hand specialist
  3. Surgical repair
    1. Indicated for static dissociations
    2. Dynamic dissociations may be treated with 2-6 weeks of Forearm cast

VIII. Complications

  1. Scapholunate advanced collapse (SLAC Wrist)

IX. References

  1. Eiff (2018) Fracture Management, Elsevier, Philadelphia, p. 99-101
  2. Swadron and Mallon in Herbert (2018) EM:Rap 18(12): 3-4

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Related Studies

Ontology: Complete tear of scapholunate ligament (C0435077)

Concepts Injury or Poisoning (T037)
SnomedCT 209602001
English Complete tear scapholunate lig, Complete tear of scapholunate ligament, Complete tear of scapholunate ligament (disorder)
Spanish desgarro completo de ligamento escafosemilunar (trastorno), desgarro completo de ligamento escafosemilunar

Ontology: Rupture of scapholunate ligament of wrist (C2317169)

Concepts Pathologic Function (T046)
SnomedCT 430892004
English Rupture of scapholunate ligament of wrist, Rupture of scapholunate ligament of wrist (disorder)
Spanish ruptura de ligamento escafosemilunar de la muñeca, ruptura de ligamento escafosemilunar de la muñeca (trastorno)

Ontology: Scapholunate advanced collapse (C3164615)

Concepts Disease or Syndrome (T047)
SnomedCT 447775001
English Scapholunate advanced collapse, Scapholunate advanced collapse (disorder)
Spanish colapso escafosemilunar avanzado (trastorno), colapso escafosemilunar avanzado