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Case of the Week 473


What is the most likely diagnosis?

  • 37 year-old male after fall on outstretched hand



Frontal Radiograph of the Wrist

  1. Lunate Dislocation
  2. Scapholunate Dissociation
  3. Perilunate Dislocation
  4. Scaphoid Fracture
  5. Rheumatoid Arthritis

Additional Images - None

 

Additional Images

 

 

None


Answer:

 

3. Scapholunate Dissociation

 

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Scapholunate Dissociation

General Considerations

  • Loss of mechanical linkage between scaphoid and lunate
  • Usually relates to complete disruption of the scapholunate interosseous ligament (SLIL)
  • Rupture of SLIL most frequently results from fall onto an outstretched hand
  • Often associated with additional injuries
    • Displaced scaphoid fractures
    • Distal radial fractures
  • Scapholunate dissociation (SLD) represents first stage in spectrum of perilunate dislocations

 

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