Scapholunate ligament complete tear

Case contributed by Andrew Dixon
Diagnosis certain


Football injury.

Patient Data

Age: 25 years
Gender: Male

No bone marrow edema or fracture apart from minimal edema in the distal aspect of the scaphoid.

The scapholunate articulation is completely disrupted with tearing of all components of the scapholunate ligament.

There is also tearing of the distal scaphotrapezoid and trapezium ligaments and partial tearing at the proximal attachment of the radioscaphocapitate ligament which is probably chronic with a number of small ganglion cysts observed. The dorsal intercarpal ligament is also partially strained with diffuse high signal.  

Flexion of the scaphoid and extension of the lunate with the proximal scaphoid subluxed dorsally relative to the distal radius in keeping with rotary subluxation of the scaphoid. The lunotriquetral ligament is intact. 

There is possibly early loss of cartilage along the proximal articular margin of the lunate. Cartilage elsewhere is intact. There is mild negative ulnar variance with compensatory thickening of the triangular fibrocartilage, the head of the styloid process is mildly deformed probably related to a past injury and there is scarring at the radial attachment of the triangular fibrocartilage. The distal radioulnar joint is normal as are wrist tendons.

Case Discussion

Scapholunate dissociation (rotary subluxation of the scaphoid) due to complete tearing of the scapholunate ligament complex.

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