The frontal wrist x-ray shows a scaphoid waist fracture.
- scaphoid axis – a line joining the most ventral point of the proximal and distal poles of the scaphoid.
- lunate axis – a line joining the midpoint of the proximal and distal articular surfaces of the lunate.
Normally, the scapholunate angle is approx. 30-60 degrees. An increased scapholunate angle indicates DISI (dorsal intercalated segmental insufficiency), which is a form of carpal instability.
It is important to diagnose this injury (DISI) so that the patient can be referred to a specialist soon after the injury.
Our patient had an obvious scaphoid fracture with DISI and underwent operative management.