SCAPHOLUNATE DISSOCIATION

Scapholunate dissociation is the most frequent serious ligamentous injury of the wrist. Untreated, this injury can lead to disabling wrist pain, reduced wrist mobility and chronic degenerative arthritis. Early recognition of the injury by careful clinical and radiographic examination results in the most favorable prognosis. Standard posteroanterior and lateral radiographs of the wrist may be inadequate. Instead, radiographs obtained with the wrist in radial and ulnar deviation or with the hand gripping forcefully may be needed to reveal the instability of this joint. Magnetic resonance imaging may be required in special cases, as it is the only imaging modality that can directly depict abnormalities of the ligaments. Surgical intervention is recommended for optimal results. Chronic injuries require specialized operative and rehabilitative management.