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The scapholunate ligament is a ligament of the wrist. [ 1 ] Rupture of the scapholunate ligament causes scapholunate instability , which, if untreated, will eventually cause a predictable pattern of wrist osteoarthritis called scapholunate advanced collapse (SLAC).
scapholunate ligament dissociation 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 ( FOOSH ), the scapholunate ligament ruptures resulting in separation of the lunate and scaphoid bones .
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 ]
A condition called scapholunate instability can occur when the scapholunate ligament (connecting the scaphoid to the lunate bone) and other surrounding ligaments are disrupted. In this state, the distance between the scaphoid and lunate bones is increased. [1]: 180
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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Wrist osteoarthritis is gradual loss of articular cartilage and hypertrophic bone changes (osteophytes). While in many joints this is part of normal aging (senescence), in the wrist osteoarthritis usually occurs over years to decades after scapholunate interosseous ligament rupture or an unhealed fracture of the scaphoid.