Posttraumatic scapholunate dissociation detected by wrist cineradiography

Thirty-two consecutive patients who had routine x-ray films were examined 12 days after wrist injury because of persistent signs and symptoms of wrist derangement. All patients had the injured and contralateral uninjured wrist examined by fluoroscopy and a scapholunate dissociation was observed in three patients. This study shows that the diagnosis of scapholunate dissociation cannot always be established by routine x-ray examination. The diagnosis should not be based solely on the size of the scapholunate gap in the injured wrist, but on the difference in the size of the gaps between the injured and contralateral uninjured wrist. The three patients with scapholunate dissociation had the defect repaired by open reduction, fixation of the scaphoid by Kirschner wires to surrounding bones, and suture of the dorsal scapholunate ligament. Two of the three patients had a satisfactory result.