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Dynamic scapholunate dissociation in a child.

George El Rassi¹, Suken A Shah

¹Balamand University, Saint George University Medical Center, Ashrafieh, Lebanon. georgeelrassi@hotmail.com

Hand Surgery : an International Journal Devoted to Hand and Upper Limb Surgery and Related Research : Journal of the Asia-Pacific Federation of Societies for Surgery of the Hand

|November 3, 2006

Summary

Dynamic scapholunate dissociation, a wrist injury, was diagnosed in a child using arthroscopy when imaging failed. Surgical stabilization restored full wrist function.

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Area of Science:

Orthopedic Surgery
Pediatric Orthopedics
Wrist Biomechanics

Background:

Scapholunate dissociation is a common wrist instability, typically seen in adults.
Diagnosis in skeletally immature patients can be challenging due to subtle radiographic findings.

Observation:

A 10-year-old girl presented with anatomical snuffbox pain and dorsal wrist swelling.
Standard static and dynamic wrist radiographs were unremarkable.
Magnetic resonance imaging (MRI) provided inconclusive results.

Findings:

Wrist arthroscopy definitively diagnosed dynamic scapholunate dissociation.
Arthroscopic reduction and standard stabilization techniques were employed.
The patient achieved full, pain-free wrist range of motion post-procedure.

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Implications:

Highlights the utility of arthroscopy in diagnosing obscure wrist instabilities in pediatric patients.
Suggests dynamic scapholunate dissociation should be considered in children with persistent wrist pain despite negative imaging.
Emphasizes the effectiveness of arthroscopic intervention for restoring function in pediatric wrist injuries.