Relevance of the Scaphoid Shift Test for the Investigation of Scapholunate Ligament Injuries

Schmauß, Daniel; Pöhlmann, Sebastian; Weinzierl, Andrea; Schmauss, Verena; Moog, Philipp; Germann, Günter; Bickert, Berthold; Megerle, Kai

doi:10.3390/jcm11216322

Cited by 4 publications

(2 citation statements)

References 22 publications

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“…Watson’s scaphoid shift test demonstrates the proximal scaphoid subluxation from the scaphoid fossa of the radius. While known for decades as a sign of scaphoid instability, the sensitivity and specificity of the scaphoid shift test are around 60–70% [ 20 , 21 ]. The prevalence of positive scaphoid shift test in the uninjured population was reported to be as high as 32% [ 22 ].…”

Section: Clinical Examinationmentioning

confidence: 99%

Current Concepts in Scapholunate Instability Without Arthritic Changes

Amarasooriya

Jerome²,

Tourret

2023

JOIO

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Scapholunate instability (SLI) is the most common carpal instability described. SLI leads to a degenerative arthritic pattern known as scapholunate advanced collapse (SLAC). Diagnosis of SLI can be challenging in pre-dynamic and dynamic stages. CT arthrogram, MR arthrogram and dynamic fluoroscopy are helpful in diagnosis while arthroscopy remains the gold standard. SLI is a multi-ligament injury, which involves not only the scapholunate interosseous ligament (SLIL) but also the extrinsic carpal ligaments. Hence, it is better described as an injury compromising the ‘dorsal scapholunate(dSLL) complex’. A repair can be attempted for acute SLI presenting within 6 weeks of injury. Reconstruction is the mainstay of treatment for chronic SLI without degenerative changes. Multiple repair techniques have been described which include capsulodesis and tenodesis procedures. The clinical outcomes of the techniques have improved over the years. However, a common problem of all these techniques is the lack of long-term data on the outcomes and deteriorating radiological parameters over time. SLI staging is an important factor to be considered in choosing the reconstruction techniques for a better outcome. Currently, there is a trend towards more biological and less invasive techniques. Regardless of the technique, it is important to preserve the nerve supply of the dorsal capsuloligamentous structures of the wrist. Arthroscopic techniques being minimally invasive have the advantage of less collateral damage to the capsuloligamentous structures. Rehabilitation involves a team approach where a protected dart thrower’s motion is allowed after a period of immobilization. Strengthening SL-friendly muscles and inhibiting SL-unfriendly muscles is a key principle in rehabilitation.

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Section: Clinical Examinationmentioning

confidence: 99%

Current Concepts in Scapholunate Instability Without Arthritic Changes

Amarasooriya

Jerome²,

Tourret

2023

JOIO

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“…Вторую группу составили пациенты с выявленными повреждениями с разделением на подгруппу с повреждениями 1-2-й степени и подгруппу с повреждениями 3-4-й степени по артроскопической классификации Geissler [17]. Подобное разделение выявило, что чувствительность и специфичность теста Watson увеличиваются в соответствии со степенью выявленного артроскопически повреждения ЛПС по Geissler [18].…”

Section: обсуждение основного результата исследованияunclassified

Clinical tests in the diagnosis of scapholunate ligament injuries

Golubev,

Gazimieva,

Sautin

et al. 2023

N.N. Priorov Journal of Traumatology and Orthopedics

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BACKGROUND:Non-invasive instrumental methods of scapholunate ligament injuries, one of the main wrist joint stabilisers, are complicated by frequent false results of examination, and therefore clinical testing is essential in making the diagnosis. At the same time, the limited number of existing specific tests requires evaluation of their prognostic accuracy. AIM:Evaluating the diagnostic significance of alternative specific tests in the diagnosis of scapholunate ligament injuries. MATERIALS AND METHODS:In this study, we performed clinical examination and testing of both carpal joints in 50 subjects who had no complaints of carpal joint dysfunction or pain and denied a history of trauma. In clinical testing, the presence or absence of pain during palpation in the projection of the scapholunate ligament was analysed, as well as the specific Watson test, the navicular balloting test and the Kleinman test, for which specificity was assessed. RESULTS:The specificity of scapholunate ligament palpation as a diagnostic test was 84.0%, Watson test — 96.0%, navicular balloting test — 98.0%, Kleinman test — 87.0%. The overall specificity of clinical tests was 79.0%. A combination of Watson test, navicular balloting test and Kleinman test achieved the highest specificity (86.0%). CONCLUSIONS:Clinical testing is an important diagnostic tool in suspected scapholunate ligament injuries, however the benefit of isolated clinical tests is not absolute and therefore the best algorithm for clinical examination of the wrist joint may be the use of several specific clinical tests in combination.

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