What is Scapholunate Dissociation?

A “FOOSH” injury is rather common for many athletes and kids. “FOOSH” stands for fall on outstretched hand. Other than the obvious scrapes that can occur, the most common injury related to this mechanism is what we classify as a sprain / strain. This infers damage to both muscles and joint structures (ligament). One specific wrist injury that can occur after falling on an outstretched hand is called scapho-lunate dissociation.

A person who experiences pain in the back of the wrist or the thumb side of the wrist (following a fall) should be examined for scapho-lunate dissociation. Our hands (right beside the area of the wrist) have many different bones in it. Two of these bones are the scaphoid and the lunate. The scaphoid is the bone that is located in the little divot that forms when we open our hand wide (near the thumb side). In a nutshell, scapho-lunate dissociation is when these two bones are forced apart due to trauma. Normally they sit closely beside each other and are held in place by ligaments. In this injury, the two bones are spread apart and the ligament that holds them close together is torn. Following this damage to the ligament structures the bones are “loose” and not as stable.

Watson’s test is a clinical orthopaedic test that the practitioner can use to help diagnose scaphoid instability. It’s an “ok” test but not a great one. Instability of the wrist can also sometimes be seen on plain x-ray. (For the x-ray reading practitioners out there, look for the Terry Thomas / David Letterman sign or the Signet Ring sign among other things).

Wrist Injury Treatment

So how do we treat this wrist injury? Like most traumatic joint injuries, the initial management involves ice and the use of therapeutic modalities. At Burlington Sports Therapy, this can be performed by our Chiropractors, Physiotherapists or our Athletic Therapist. There are options as to how we go about the immediate reduction of symptoms, but laser therapy and or interferential therapy are common strategies. Acupuncture can also be considered as a way to reduce the initial symptoms associated with this injury. Unfortunately in the long term, patients with severe scapho-lunate dissociation require surgery or at least a consultation with a surgeon.

Do you have wrist pain? Unsure what it is? The first step in recovery is getting an accurate diagnosis. We can assist you with that step of the process. That is the key step in determining the most appropriate course of management for your condition. Give us a call today at (905) 220-7858! We treat athletes and people in the Oakville, Burlington, Hamilton and Milton area.