Scapholunate Spacing——–Normal Copy

. ONE-LINERS re DISRUPTION OF SCAPHOLUNATE LIGAMENT

·  The scaphoid and lunate bones have no muscle attachments and their main purpose is to stabilize the wrist joint.

·  A disruption of the scaspholunate ligament is best appreciated on the AP wrist view. Ask for a clenched fist view .

·  If the spacing is > 4 mm it is virtually diagnostic (see Illustrations 79 and 80). This is commonly called the Terry Thomas Sign –named after the British comedian who has a wide gap between his central incisors.

·  When this ligamentous wrist injury occurs, the patient will usually complain of pain, weakness and a ” click ” during use.

·  Next level study- consider CT scan or MRI.

·  If this ligamentous injury goes undetected and untreated– it may progress to severe arthritis, pain and limited range of motion.

This is known as SLAC ( ScaphoLunate Advanced Collapse ).

 

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Illustration 79 Normal Scapholunate Spacing


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for an example of Scapholunate Separation