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Lunate Dissociation, Sports Medicine

Aleem Bakhtiar, MS, MD and Kory Gill, DO, FAAFP, CAQSM Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Dissociation, or dislocation, is classified by the pattern of carpal collapse, either dorsal or volar in nature, after wrist trauma or injury.

  • The carpal bones in the wrist are stabil...

DIAGNOSIS

HISTORY

  • Determine duration of pain: Most patients present acutely, but some report a history of painful clicking, reduced grip strength, and giving way with activities.

  • Obtain detailed mechani...

TREATMENT

  • Acute treatment

  • Analgesia; nonsteroidal anti-inflammatory drugs (NSAIDs), narcotics

  • Reduction techniques:

    • Only for least severe injury (e.g., dynamic instability; see above)

    • Recommended for expe...

REFERENCES

1
Lau S, Swarna SS, Tamvakopoulos GS. Scapholunate dissociation: an overview of the clinical entity and current treatment options. Eur J Orthop Surg Traummot.  2009;19(6):377–385.
2
Grabo...

ADDITIONAL READING

  • Cohen MS. Ligamentous injuries of the wrist in the athlete. Clin Sports Med.  1998;17(3):533–552.

  • Manuel J, Moran SL. The diagnosis and treatment of scapholunate instability. Or...

CLINICAL PEARLS

  • Surgery results in ~35% loss of flexion and extension. This should still allow an athlete to return to activity in most cases.

  • The ligament in the wrist has torn in this injury, and the...

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