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A lumberjack in rural Michigan falls 10 feet from an Evergreen branch onto an outstretched arm and develops immediate wrist pain. He is not able to see a physician for 4 months. When he finally does, he is diagnosed with a perilunate dislocation and indicated for a Proximal Row Carpectomy (PRC). Figure A is an intraoperative photo. The black dot in the photo is the capitate. The instrument touches a structure that prevents ulnar translocation of the carpus after a PRC. What is this structure?
Short Radiolunate ligament (SRL)
Lunotriquetral ligament (LTL)
Radioscapholunate ligament (RSL)
Scapholunate ligament (SL)
Radioscaphocapitate ligament (RSC)
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A 35-year-old professional football player complains of severe wrist pain after making a tackle. He reports paresthesias in his thumb and index finger. AP and lateral radiographs of the wrist are shown in figures A and B respectively. What is the most appropriate next step in management?
short arm thumb spica cast
long arm thumb spica cast
urgent closed reduction and splinting
MR arthrogram of the wrist to assess ligamentous injuries
bone scan to assess vascularity