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Scapholunate Dislocation
Aka: Scapholunate Dislocation, Scapholunate Dissociation, Scapholunate Ligament Rupture, Scapholunate Tear, Complete Scapholunate Ligament Rupture, Scapholunate advanced collapse, SLAC Wrist
- Mechanism
- Fall on Outstretched Hand
- Scapholunate interosseous ligament is disrupted resulting in instability
- Symptoms
- Radial aspect Wrist Pain, worse with gripping
- Imaging
- Wrist XRay
- Scaphoid Bone and Lunate Bones separated 3 mm or more (aka Terry Thomas Sign, David Letterman Sign)
- Clenched-Fist View
- Accentuates widening between the Scaphoid Bone and the Lunate Bone
- Differential Diagnosis
- Scaphoid Fracture
- Distal Radius Fracture
- Associated Conditions
- Median Nerve injury
- Lunate Avascular Necrosis
- Management
- Immobilization in short arm volar splint
- Refer to orthopedics or orthopedic hand specialist
- Surgical repair
- Indicated for static dissociations
- Dynamic dissociations may be treated with 2-6 weeks of Forearm cast
- Complications
- Scapholunate advanced collapse (SLAC Wrist)
- References
- Eiff (2018) Fracture Management, Elsevier, Philadelphia, p. 99-101
- Swadron and Mallon in Herbert (2018) EM:Rap 18(12): 3-4