Diagnostics of scapho-lunate ligament injury
Keywords:scapho-lunate ligament, diagnostics, X-ray, ultrasound
The main problem in the diagnostics of scapho-lunate ligament injury is the relative rare detailed clinical and radiologic picture, the lack of information and pronounced dissonance between anatomic types if injuries and clinical symptoms.
Methods: we examined 63 patients (47 men, 16 female, average age 34.4 years) who had surgery treatment because of scapho-lunate ligament injury. We assessed the informative (sensitivity/specificity) of clinical signs and data obtained with X-ray, computer tomography, magnetic resonance investigation and ultrasound.
Results: in the basis of scapho-lunate ligament injury lies the progressive instability with extensor contracture and degenerative changes in radial joint. The diagnostics of the early stages of ligament injury is based on anamnesis morbid and quite sensitive clinical tests: Watson — 96 %, scapho-lunate displacement — 53 %, «flexed wrist-extension fingers» — 75 %. But because of their low specificity (4–6 %) additional methods of examination are needed — X-ray, computer tomography, magnetic resonance investigation, ultrasound.Conclusions: for those injuries which accompined with static instability we use X-ray or computer tomography in order to identify such signs as «Terry Thomas» symptom, «ring», scaphoid shortening. Their sensitivity at the IV–VI stages is almost 100 %. In cases of I–III stages of ligament injury the most specificity is magnetic resonance investigation study. Ultrasound is high informative at ligament injury and carpal instability, but it does not give the full picture of disorganization of wrist joint, it does not give opportunity to divide the stage of injury and choose the method of treatment, so it can be as additional method of examination
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