Month: September 2021

Wrist injury series – Scapholunate dissociation

Scapholunate dissociation

What is it

An injury involving a stretch or tear of the scapholunate ligament which can affect the way the
scaphoid and lunate bones interact.


Often occurs when a person experiences a fall onto an outstretched hand where the wrist is
forced into a position of hyperextension and ulnar deviation which causes a stretching or tearing
of the ligaments between the scaphoid and lunate. Distal radius fractures are often associated
with scapholunate dissociation.

Clinical presentation

● History of a fall onto an outstretched hand
● Pain/clicking on the dorso-radial aspect of the wrist
● Reduced grip strength
● Tenderness 2cm distal to Lister’s tubercle on the radial side of the lunate
● Tenderness in the proximal end of the anatomical snuffbox
● Watson test: either painful or reveals dorsal movement of the scaphoid
● X-ray while gripping an object is useful for diagnosis


● For incomplete tears where there is no instability of the scapholunate joint,
splinting/casting to immobilise the joint may be required
● Taping to improve stability
● Avoiding aggravating activities
● Regaining pain-free movement and strength through joint mobilisation and strengthening
● For complete tears specialist opinion is recommended as surgical intervention may be

Wrist injury series – TFCC injury

TFCC irritation

What is it?

Triangular Fibrocartilage Complex (TFCC) is a cartilage structure that lies between the ulna and
carpus. The function of the TFCC is to act as the main stabiliser of the distal radioulnar joint.

TFCC anatomy


Often injured in forced ulnar deviation or falling on an outstretched hand. Common in racquet or
stick sports and those that create repetitive ulnar and compressive loading including
gymnastics, weight lifting, boxing and surfing. TFCC injury should be investigated following a
distal radius fracture and wherever distal radioulnar joint (DRUJ) instability exists.

Clinical presentation

● Ulnar sided pain that worsens with grip, rotation and weight bearing
● Clicking sensation on wrist movement
● Point tenderness between the pisiform and the ulnar head
● Reduced grip strength
● Pain on resisted wrist extension and ulnar deviation
● Positive foveal sign = sharp pain with deep palpation
● Positive press test = reproduction of pain when lifting own weight up off a chair using the
affected wrist
● MRI imaging is useful for diagnosis of these injuries


● Avoiding aggravating activities
● Avoiding repetitive wrist movements and trying to keep wrist in a neutral position where
● Short period of splinting
● Tape to offload the TFCC
● Stabilisation exercises particularly involving ECU and pronator quadratus instability as a result of a complete ligamentous rupture often requires surgery as soon as possible.

Jersey Day 2021

Jersey Day is all about raising awareness – there is no requirement to raise funds. Jersey Day is fun, it’s free and by registering to become an organ and tissue donor you could be helping to save a life.


Each Jersey Day we ask schools and workplaces across Australia to allow students and employees to wear their favourite sporting jersey to school or work and begin the conversation with their family and friends about the importance of becoming an organ and tissue donor. Jersey Day was inspired by the gift of life that Nathan Gremmo (pictured) gave to six people when he became an organ donor at age 13.

#donatelife #jerseydayau

Jessica, Max and Tom wearing their jerseys with pride.