Summary about Disease
Scapholunate dissociation is a wrist injury involving a disruption of the ligaments connecting the scaphoid and lunate bones. This instability can lead to pain, clicking, and eventual arthritis if left untreated. The scapholunate ligament is the primary stabilizer between these two bones, and when it tears, the normal mechanics of the wrist are disrupted. This alters carpal alignment and load distribution.
Symptoms
Wrist pain, especially on the back of the wrist (dorsal side).
Clicking, snapping, or popping sensation in the wrist.
Weakness in grip strength.
Swelling around the wrist.
Pain that worsens with activity, particularly weight-bearing or rotational movements.
A feeling of instability or giving way in the wrist.
Causes
Trauma to the wrist, such as a fall onto an outstretched hand.
Repetitive stress injuries involving the wrist.
Underlying ligamentous laxity (general looseness of ligaments).
A direct blow to the wrist.
Sports injuries.
Medicine Used
4. Medicine used
Pain relievers: Over-the-counter pain relievers like ibuprofen (Advil, Motrin) or naproxen (Aleve) can help manage pain and inflammation. Prescription pain medications may be necessary for severe pain.
Corticosteroid injections: Injections into the wrist joint can reduce inflammation and provide temporary pain relief.
No medications can heal the ligament tear directly. Surgery or other interventions (like casting) are required for repair or stabilization.
Is Communicable
Scapholunate dissociation is not communicable. It is a result of injury and not caused by an infectious agent.
Precautions
Avoid activities that aggravate wrist pain.
Use wrist supports or splints as recommended by a doctor or physical therapist.
Strengthen wrist and forearm muscles with appropriate exercises.
Modify activities to reduce stress on the wrist.
Proper technique and protective gear during sports or activities with a risk of wrist injury.
How long does an outbreak last?
Scapholunate dissociation is not an outbreak. It is a condition resulting from injury. Symptoms can persist indefinitely if the underlying ligament injury is not addressed. The duration of symptoms depends on the severity of the injury, the individual's activity level, and whether appropriate treatment is received.
How is it diagnosed?
Physical Examination: A doctor will assess wrist range of motion, stability, and areas of tenderness. Specific tests, such as the Watson test (scaphoid shift test), are used to evaluate scapholunate instability.
X-rays: Standard X-rays may reveal a widened scapholunate interval (space between the scaphoid and lunate bones). Clenched fist views or stress radiographs can highlight instability.
MRI (Magnetic Resonance Imaging): MRI provides detailed images of the ligaments and soft tissues, allowing visualization of scapholunate ligament tears and associated injuries.
Arthroscopy: In some cases, arthroscopy (a minimally invasive surgical procedure) may be used to directly visualize the ligaments and assess the extent of the damage.
Timeline of Symptoms
9. Timeline of symptoms
Acute Phase (Immediately after injury): Sudden wrist pain, swelling, and limited range of motion.
Subacute Phase (Days to weeks after injury): Pain may decrease, but instability and clicking may become more noticeable. Weakness in grip strength develops.
Chronic Phase (Months to years after injury): Persistent pain, clicking, and weakness. The wrist may feel unstable. Arthritis can develop over time.
Important Considerations
Early diagnosis and treatment are crucial to prevent long-term complications, such as arthritis.
Treatment options range from conservative management (splinting, therapy) to surgical repair or reconstruction, depending on the severity and chronicity of the injury.
Surgical outcomes are generally better when the injury is addressed early.
Recovery after surgery can take several months and requires dedicated rehabilitation.
Even with treatment, some individuals may experience residual pain or stiffness.