Fracture of the radial styloid process with scapholunate dissociation

Case contributed by Bálint Botz
Diagnosis certain


Sustained a FOOSH, injured the left wrist.

Patient Data

Age: 65 years
Gender: Male
  • Minimally depressed fracture of the radial styloid process.
  • Small, sclerotic fragments radially adjacent to the scaphoid. May represent prior trauma, calcification, or extranumerary bones. 
  • Increased SL distance with Terry Thomas sign. 
  • Mild negative ulnar variance. 
  • Depressed radial styloid process fracture, increased SL distance and negative ulnar variance redemonstrated. 
  • Small, sclerotic foci adjacent to the scaphoid likely represent degenerative changes rather then acute trauma.  
  • Small bone island in the capitate with no clinical significance. 

Status post ORIF with nail and volar locking plate, radiograph taken in cast. Increased SL distance and negative ulnar variance redemonstrated. 

Case Discussion

Scapholunate interval and ulnar variance should be carefully assessed on every trauma wrist exam taken post FOOSH. 

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