Beware the sprained wrist. The incidence and diagnosis of scapholunate instability

A consecutive series of 100 cases of wrist injury, other than those referred with a radial fracture, have been reviewed to determine the incidence of acute scapholunate instability; a "clenched fist" radiograph was used in addition to the routine scaphoid views. Of 19 patients with an increase in the scapholunate gap, five were eventually considered to have significant scapholunate instability, two in association with Colles' fractures. Injuries producing significant ligamentous damage and carpal instability may be as common as scaphoid fractures. They require special consideration in diagnosis and management.