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Scapholunate Ligament Injury

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Sports Injuries of the Hand and Wrist

Part of the book series: In Clinical Practice ((ICP))

Abstract

In this chapter on scapholunate ligament injury, we first describe wrist anatomy and biomechanics so that the reader can then have an understanding of the pathomechanics of scapholunate dissociation and its classification. We then take the reader through the diagnosis of scapholunate ligament injury including clinical assessment, imaging and other useful investigations. We then explain our algorithmic approach to aid decision-making but emphasise the need to tailor treatment to the individual as these cases are complex and often difficult to manage.

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Author information

Authors and Affiliations

  1. Department of Plastic Surgery, York Teaching Hospital NHS Foundation Trust, York, UK

    Jonathan Adamthwaite

  2. Institut Kaplan, Barcelona, Spain

    Sina Babazadeh & Marc Garcia-Elias

Authors
  1. Jonathan Adamthwaite
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  2. Sina Babazadeh
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  3. Marc Garcia-Elias
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Corresponding author

Correspondence to Marc Garcia-Elias .

Editor information

Editors and Affiliations

  1. Upper Limb Unit, Wrightington Hospital, Wigan, UK

    Mike Hayton

  2. Upper Limb Unit, Wrightington Hospital, Wigan, UK

    Chye Yew Ng

  3. Upper Limb Unit, Wrightington Hospital, Wigan, UK

    Lennard Funk

  4. Upper Limb Unit, Wrightington Hospital, Wigan, UK

    Adam Watts

  5. Upper Limb Unit, Wrightington Hospital, Wigan, UK

    Mike Walton

Questions and Answers

Questions and Answers

Questions

  1. 1.

    Which is the correct answer? Place the following structures in order of decreasing yield strength:

    1. (a)

      Proximal SL ligament, proximal SL membrane, dorsal SL ligament

    2. (b)

      Proximal SL membrane, proximal SL ligament, dorsal SL ligament

    3. (c)

      Dorsal SL ligament, proximal SL membrane, proximal SL ligament

    4. (d)

      Dorsal SL ligament , proximal SL ligament, proximal SL membrane

    5. (e)

      Proximal SL ligament, dorsal SL ligament, proximal SL membrane

  2. 2.

    Which is the most common plane of wrist motion?

  3. 3.

    What ultimately stabilises the wrist?

  4. 4.

    True or false? SLD is most likely to be diagnosed in the acute phase.

  5. 5.

    What is a positive scaphoid shift test?

Answers

  1. 1.

    (d)

  2. 2.

    The dart-thrower’s plane of wrist motion is the most commonly used in daily activities, going from extension and radial inclination to flexion and ulnar inclination.

  3. 3.

    The muscles are the ultimate stabilisers of the wrist with the ligaments the first line of defence providing proprioceptive feedback .

  4. 4.

    False. More commonly, SLD is diagnosed in the subacute or chronic phase, when the derangement is evident on plain radiographs. This occurs because progressive instability has led to the deterioration of the secondary stabilisers, particularly the STT ligament, and is now a complex multilevel ligament injury.

  5. 5.

    A positive scaphoid shift test is when painful subluxation of the proximal pole of the scaphoid is elicited when the wrist is moved passively from ulnar to radial inclination with four fingers placed behind the radius and the thumb placed on the scaphoid tuberosity.

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Adamthwaite, J., Babazadeh, S., Garcia-Elias, M. (2019). Scapholunate Ligament Injury. In: Hayton, M., Ng, C., Funk, L., Watts, A., Walton, M. (eds) Sports Injuries of the Hand and Wrist. In Clinical Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-02134-4_11

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  • DOI: https://doi.org/10.1007/978-3-030-02134-4_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-02133-7

  • Online ISBN: 978-3-030-02134-4

  • eBook Packages: MedicineMedicine (R0)

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