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In radiology, the Terry-Thomas sign is a scapholunate ligament dissociation on an anteroposterior view of the wrist. [1] [2] Most commonly a result of a fall on the outstretched hand , the scapholunate ligament ruptures resulting in separation of the lunate and scaphoid bones. This burst causes the scaphoid bone to dorsally rotate. [3]
X-ray images indicate scapholunate ligament instability when the scapholunate distance is more than 3 mm, which is called scapholunate dissociation. [7] A static scapholunate instability is generally readily visible, but a dynamic scapholunate instability can only be seen radiographically in certain wrist positions or under certain loading conditions, such as when clenching the wrist, or ...
Scapholunate advanced collapse (also known as SLAC wrist) is a type of wrist osteoarthritis. SLAC wrist is the most common type of post-traumatic wrist osteoarthritis [ 1 ] and is often the result of an undiagnosed or untreated scapholunate ligament rupture. [ 2 ]
Instability in the wrist can be caused by a torn Scapholunate ligament. The Brunelli Procedure does not fix the torn ligament. A hole is drilled through the Scaphoid bone and a part of a tendon taken from the patient is put through this hole and attached to the nearby bones. The procedure usually results in reduced movement of the wrist.
The physical exam may show tenderness by palpation over the scapholunate ligament on the back of the wrist, immediately below the radius. [1] [4] Swelling and deformities are the two clinical signs associated with arthritis. The wrist is clinically tested by slight flexion while the physician feels the back of the wrist with the thumb. [4]
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Scapholunate advanced collapse is the most common form, followed by scaphoid non-union advanced collapse (SNAC). [3] Other post-traumatic causes such as intra-articular fractures of the distal radius or ulna can also lead to wrist osteoarthritis, but are less common.
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