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Scapholunate dissociation with dorsal intercalated segmental instability

Case contributed by Bahman Rasuli
Diagnosis almost certain

Presentation

Falling down with outstretched right hand.

Patient Data

Age: 45 years
Gender: Male

Tearing of the all components of scapholunate ligament involving the central and dorsal components is seen causing to the widening of the scapholunate distance measuring about 6 mm (Terry-Thomas sign).

The lunate is dorsally tilted. The scaphoid is dissociated from the motion of the lunate and is tilted volar. Lateral scapholunate angle is 105 degrees.

Bone marrow edema/bruise also is seen at the distal of radius, scaphoid and capitate bones.

Small mid carpal joint effusion is noted.

Case Discussion

Scapholunate dissociation and dorsal intercalated segmental instability due to complete tearing of the scapholunate ligament complex.

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