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Scapholunate advanced collapse (SLAC) and dorsal intercalated segmental instability (DISI)

Case contributed by Domenico Nicoletti
Diagnosis almost certain

Presentation

Pain and functional limitation in trauma outcomes.

Patient Data

Age: 60 years
Gender: Male

Scapholunate ligament tear with scaphoid rotational subluxation and lunate dorsal tilt; capitate slight proximal subluxation. Signs of carpal osteoarthritis (scapholunate advanced collapse).

Normal triangular fibrocartilage complex. Small joint effusion.

Case Discussion

Scapholunate dissociation refers to the interruption of the mechanical connection between the scaphoid and lunate due to scapholunate ligament tear (Terry Thomas sign). It is the most common cause of carpal instability and can occur in isolation or in association with scaphoid fractures. Scaphoid rotational subluxation represents an advanced stage of the condition.

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