Watson Test / Scaphoid Shift Test | Scapholunate Instability

Watson Test / Scaphoid Shift Test | Scapholunate Instability


In this video I’m going to show you how to do the Watsons or scaphoid shift test for scapholunate ligament rupture at the wrist. Hi and welcome back to Physiotutors. The scapholunate ligament is a strong ligament between the scaphoid and the lunate and an important stabiliser of the wrist. It can be injured by a fall or sudden load on the wrist and can occur together with a distal radius fracture or carpal fracture. When untreated an SL tear can lead to a so called DISI Which stands for dorsal intercalated segmental instability, which is a dissociation of the scaphoid and the lunate. According to a review of Valdes et al. in the year 2013 the Watson test has a positive mean likelihood ratio of 2.76 and a negative mean likelihood ratio of 0.25 which means that this test has a moderate clinical value to rule out SL ligament tears But a low value to confirm an SLT. To perform the Watson test your patient is in sitting position with his elbow supported on the treatment bench and facing the examiner. Then fixate your patients radius with one hand and give pressure on the palmar prominence of the scaphoid with your thumb into dorsal direction with the other hand grasp the patient’s metacarpals from the ulnar side to control the wrist. Start an ulnar deviation and slight extension. In this position, The long axis of the scaphoid is nearly in line with the axis of the radius. Then move the wrist into radial deviation and slight flexion while you keep pressure on the scaphoid. Because the scaphoid wants to move into flexion with radial deviation, the oppositional force of the thumb will cause it to shift or sublux in dorsal direction in case of an SL ligament rupture. When the pressure of the thumb is released the scaphoid often shifts back in palmar direction with a “thunk”. So, this test is positive for an SL ligament rupture if such a “thunk” can be felt or heard, or if it reproduces the patient’s familiar wrist pain on the dorsal side. In a healthy wrist the movement into radial deviation will either just be limited or the scaphoid just pushes the thumb away in palmar direction. All right, this was our video on the Watsons or scaphoid shift test. If you want to find out if your patient has a TFCC lesion check out the video right next to me. At last if you liked this video please give it a thumbs up, subscribe to our channel if you haven’t and check out our newly released physiotherapy assessment ebook that you can find in the bottom left corner. This was Kai for physio tutors. Thanks a lot for watching. I’ll see in the next video. Bye

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