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The scapholunate ligament is a ligament of the wrist. [1] ... The Watson's test may be used in diagnosis. Static scapholunate dissociation. Dynamic instability ...
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]
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]
Because SLAC results from scapholunate ligament rupture, there is a larger space between the two bones, also known as the Terry Thomas sign. [10] Scaphoid instability due to the ligament rupture can be stactic or dynamic. [11] When the X-ray is diagnostic and there is a convincing Terry Thomas sign it is a static scaphoid instability.
The examiner will feel a significant 'clunk' and the patient will experience pain if the test is positive. For completeness, the test must be performed on both wrists for comparison. If the scapholunate ligament is disrupted, the scaphoid will subluxate over the dorsal lip of the distal radius. Original Description by Watson:
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The initial treatment of patients with a suspected tear of the scapholunate and lunotriquetral interosseous ligament is a splint of the wrist. If the pain and instability persists, one could undergo an open surgery to reconstruct the scapholunate ligament. The lunotriquetral shear test may also be used.
Seventy-four percent were using Suboxone to ease withdrawal symptoms while sixty-four percent were using it because they couldn’t afford drug treatment. The researchers noted: “Common reasons given for not being currently enrolled in a buprenorphine/naloxone program included cost and unavailability of prescribing physicians.”