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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 ...
When the X-ray is diagnostic and there is a convincing Terry Thomas sign it is a static scaphoid instability. When the scaphoid is made unstable by either the patient or by manipulation by the examining physician it is a dynamic instability. [11] SNAC. In order to diagnose a SNAC wrist you need a PA view X-ray and a lateral view X-ray.
The term navicular bone or hand navicular bone was formerly used for the scaphoid bone, [1] one of the carpal bones of the wrist. The navicular bone in humans is located on the medial side of the foot, and articulates proximally with the talus, distally with the three cuneiform bones, and laterally with the cuboid.
While the structure of the head and face were not very far removed from those of modern humans, there were still quite noticeable differences. Notably the neanderthal head is much longer, with a more pronounced facial front. The Neanderthal chin and forehead sloped backwards and the nose region protruded forward more than in modern humans.
[1]: 6 It, along with the lunate bone, articulates with the radius and ulna to form the major bones involved in movement of the wrist. [5] The scaphoid serves as a link between the two rows of carpal bones. With wrist movement, the scaphoid may flex from its position in the same plane as the forearm to perpendicular. [1]: 176–177
The PA wrist x-ray will demonstrate sclerosis and joint space narrowing between the lunate and capitate. Over time, the capitate will migrate proximally into the space created by the scapholunate dissociation. [2] The radiographic findings in Stage III SLAC wrist are synonymous with the Terry-Thomas sign, indicating complete scapholunate ...
Once the cast has been removed, the patient begins physiotherapy to regain the range of movement of the wrist joint and strength in the muscles involved. If X-rays show that the capitate fracture fragments are out of alignment, surgery is indicated. A surgeon can use small compression screws or K-wires to unite the two pieces of bone.