Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Dislocations around the Wrist

Dislocations around the wrist are rare in sports, but are important to recognize because a good recovery depends on early and correct diagnosis and treatment. Even with proper treatment, these injuries often have long-term residual symptoms.

Separation between the scaphoid and lunate

Scapholunate dissociation may occur in forced dorsiflexion of the wrist. Ligamentous disruption between the scaphoid and lunate bones will cause the two bones to separate. This injury is felt to be a less severe form of the same mechanism that causes perilunate dislocation.

Symptoms and diagnosis

– Pain is felt on movement.
– There is swelling of the wrist, and tenderness over the lunate and scaphoid.
– An X-ray shows an increased joint space between the scaphoid and the lunate and/or an abnormal angle between the scaphoid and lunate.

Treatment

The athlete should:
– cool, compress, and elevate the wrist;
– consult a doctor.

The doctor may:
– verify the diagnosis by X-ray;
– surgically reduce the displacement, suture the ligament and joint capsule, and hold the reduction with Kirschner wires;
– immobilize the joint for 8–12 weeks.

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