Fractures and dislocations: Watson scaphoid shift test: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Fractures and dislocations: Watson scaphoid shift test

Sample item

The examiner presses a thumb on the palmar tubercle of the scaphoid while moving the patient's wrist from ulnar to radial deviation. A painful dorsal clunk is produced. What does this indicate?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Scapholunate ligament instability

In the Watson test, pressure prevents the scaphoid from flexing as the wrist moves into radial deviation, and a lax scapholunate ligament lets the proximal pole subluxate dorsally. It is painful and gives a clunk when released. Scapholunate dissociation may be seen on a clenched fist view as a widened gap.

Option by option

  • A. Lunotriquetral ligament tear

    The lunotriquetral ligament is tested with the shuck or ballottement test.

  • B. Triangular fibrocartilage complex tear

    TFCC tears are tested with the ulnar fovea sign and the ulnocarpal stress test.

  • C. Scapholunate ligament instability (correct)

    Correct. The dorsal subluxation of the scaphoid proximal pole shows scapholunate instability.

  • D. Fracture of the hook of the hamate

    A hook of hamate fracture is tender over the hypothenar eminence and is not related to scaphoid shift.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Scapholunate ligament instability. In the Watson test, pressure prevents the scaphoid from flexing as the wrist moves into radial deviation, and a lax scapholunate ligament lets the proximal pole subluxate dorsally.

Why is "Lunotriquetral ligament tear" not the answer?

The lunotriquetral ligament is tested with the shuck or ballottement test.

Why is "Triangular fibrocartilage complex tear" not the answer?

TFCC tears are tested with the ulnar fovea sign and the ulnocarpal stress test.

Why is "Fracture of the hook of the hamate" not the answer?

A hook of hamate fracture is tender over the hypothenar eminence and is not related to scaphoid shift.

What concept does this question test?

It tests Fractures and dislocations: Watson scaphoid shift test in Orthopaedics. It is painful and gives a clunk when released. Scapholunate dissociation may be seen on a clenched fist view as a widened gap.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Fractures and dislocations: Watson scaphoid shift test?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.