Diagnostics of scapho-lunate ligament injury


  • Sergey Strafun
  • Sergey Timoshenko
  • Katerina Radchenko




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

Author Biographies

Sergey Strafun

SI «Institute of Traumatology and Orthopaedics of the National Academy of Medical Sciences of Ukraine», Kyiv 

MD, Prof. in Traumatology and Orthopaedics 


Sergey Timoshenko

SI «Institute of Traumatology and Orthopaedics of the National Academy of Medical Sciences of Ukraine», Kyiv 



Katerina Radchenko

SI «Institute of Traumatology and Orthopaedics of the National Academy of Medical Sciences of Ukraine», Kyiv 



Kuo, C. E., & Wolfe, S. W. (2008). Scapholunate Instability: Current Concepts in Diagnosis and Management. The Journal of Hand Surgery, 33(6), 998-1013. doi:10.1016/j.jhsa.2008.04.027

Chennagiri, R. J., & Lindau, T. R. (2013). Assessment of scapholunate instability and review of evidence for management in the absence of arthritis. Journal of Hand Surgery (European Volume), 38(7), 727-738. doi:10.1177/1753193412473861

Mayfield, J. K., Johnson, R. P., & Kilcoyne, R. K. (1980). Carpal dislocations: Pathomechanics and progressive perilunar instability. The Journal of Hand Surgery, 5(3), 226-241. doi:10.1016/s0363-5023(80)80007-4

Destot, E. (1925). Injuries of the wrist: aradiological study (pp. 101–113). London: Ernest Benn Ltd.

Linscheid, R. L., Dobyns, J. H., Beabout, J. W., & Bryan, R. S. (1972). Traumatic Instability of the Wrist. The Journal of Bone & Joint Surgery, 54(8), 1612-1632. doi:10.2106/00004623-197254080-00003

Nelson, D. L. (1997). The importance of the physical examination. Hand clinics, 13(1), 13–15.

Andersson, J. K., Andernord, D., Karlsson, J., & Fridén, J. (2015). Efficacy of magnetic resonance imaging and clinical tests in diagnostics of wrist ligament injuries: A systematic review. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 31(10), 2014-2020.e2. doi:10.1016/j.arthro.2015.04.090

Andersson, J. K., & Garcia-Elias, M. (2012). Dorsal scapholunate ligament injury: a classification of clinical forms. Journal of Hand Surgery (European Volume), 38(2), 165-169. doi:10.1177/1753193412441124

Watson, H. K., Ashmead, D., & Makhlouf, M. V. (1988). Examination of the scaphoid. The Journal of Hand Surgery of the American Society for Surgery of the Hand, 13(5), 657–560.

Watson, K. H., & Weinzweig, J. (2001). The wrist. Philadelphia: Lippincott Williams & Wilkins.

Mann, F. A., Wilson, A. J., & Gilula, L. A. (1992). Radiographic evaluation of the wrist: what does the hand surgeon want to know? Radiology, 184(1), 15-24. doi:10.1148/radiology.184.1.1609073

Gilula, L. A., & Yin, Y. (1996). Imaging of the wrist and hand (pp. 539–540). Philadelphia: W.B. Saunders.

Greditzer, H. G., Zeidenberg, J., Kam, C. C., Gray, R. R., Clifford, P. D., Mintz, D. N., & Jose, J. (2016). Optimal detection of scapholunate ligament tears with MRI. Acta Radiologica, 57(12), 1508-1514. doi:10.1177/0284185115626468

Lee, R. K., Griffith, J. F., Ng, A. W., Nung, R. C., & Yeung, D. K. (2016). Wrist Traction During MR Arthrography Improves Detection of Triangular Fibrocartilage Complex and Intrinsic Ligament Tears and Visibility of Articular Cartilage. American Journal of Roentgenology, 206(1), 155-161. doi:10.2214/ajr.15.14948

Vovchenko, G. Ya., Sergienko, R. O., Tymoshenko, S. V., & Filippchuk, V. V. (2011). Guide for ultrasound examination in traumatology and orthopedics. Joints Etudes of modern ultrasound diagnostics. Kiev: Ukrainian Doppler Club.






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