Wrist · Ligament & Arthritis
Scapholunate Ligament Injury
The scapholunate ligament stabilizes the scaphoid and lunate bone to one another in the wrist. Injuries may occur to this ligament during sports activities or falls, and when left untreated can eventually lead to wrist arthritis.
Call our office · (623) 264-3300One Ligament, Three Parts
The scapholunate ligament links the scaphoid and lunate bones of the wrist.
Dorsal Portion
The portion of the ligament most important to stability between the two bones.
Membranous Portion
The central portion of the ligament between the two bones.
Volar Portion
The portion of the ligament on the palm side of the wrist.
Overview
How Scapholunate Injuries Happen
The scapholunate ligament stabilizes the scaphoid and lunate bone to one another in the wrist. This ligament has a dorsal portion, a membranous portion, and a volar portion.
Injuries may occur to this ligament during sports activities or falls. Occasionally, an injury may be associated with fractures or dislocations of the wrist.
Why the Injury Matters
- The ligament holds the scaphoid and lunate in proper alignment
- Injury may occur during sports activities or following a fall
- It may occasionally accompany fractures or dislocations of the wrist
- When left unaddressed, instability can progress to wrist arthritis
When to Seek Evaluation
If wrist pain is persisting after a fall or sports injury, an evaluation can help determine whether the scapholunate ligament is involved.
Request an AppointmentTreatment Options
Conservative Treatment & Imaging
Mild sprains of the scapholunate ligament may be responsive to conservative treatment. When pain persists despite conservative treatment, advanced imaging with MRI may be considered.
Over-the-Counter Medication
Over-the-counter medication is one of the conservative options your treating physician may discuss for a mild sprain.
Splinting
Splinting may be used as part of a conservative treatment program for a mild scapholunate ligament sprain.
Supervised Exercise
A supervised therapeutic exercise program may be part of conservative treatment for a mild sprain.
MRI Imaging
When pain persists despite conservative treatment, advanced imaging with MRI may be considered. This decision should be discussed with your treating physician.
Why the Injury Can Be Missed
Scapholunate ligament injuries may occur alongside fractures or dislocations of the wrist, which can draw attention away from the ligament itself. Mild sprains may respond to conservative care, while more significant injuries may require further evaluation to characterize the damage.
Surgical Treatment
Repair & Reconstruction
The appropriate surgical approach depends on whether the injury is partial or complete, acute or chronic, and whether arthritis has developed.
Wrist Arthroscopy
In some patients with partial scapholunate ligament injuries, surgical wrist arthroscopy helps to further characterize the injury and assists with further treatment decisions.
Repair With Suture Anchor
Acute complete tears of the scapholunate ligament are commonly repaired with the assistance of a suture anchor.
Ligamentous Reconstruction
In cases without arthritis and a complete chronic scapholunate ligament injury, ligamentous reconstructive options may be considered.
How a Tendon Reconstruction Works
In one reconstructive technique, a portion of the tendon is taken from your forearm and passed through a tunnel drilled inside the scaphoid bone. This tunneled portion of the tendon is then connected to the lunate with a suture anchor.
Tendon Graft Harvested
A portion of tendon is taken from the forearm.
Tunnel Drilled
The graft is passed through a tunnel drilled inside the scaphoid bone.
Connected to the Lunate
The tunneled portion of tendon is connected to the lunate with a suture anchor.
When Arthritis Develops
SLAC Arthritis
When arthritis and associated symptoms occur with a scapholunate ligament injury, your physician may discuss a condition called SLAC (scapholunate advanced collapse arthropathy).
When arthritis develops, splinting, over-the-counter medications, and/or cortisone injection into the wrist joint may assist localized symptoms.
Non-Operative Options for SLAC
- Splinting
- Over-the-counter medications
- Cortisone injection into the wrist joint
These may assist localized symptoms.
Surgical Options for SLAC Arthritis
In cases of arthritis where conservative treatment does not alleviate symptoms, surgical options include treatments such as:
Scaphoid Excision & Partial Wrist Fusion
Also referred to as arthrodesis — the scaphoid is removed and a portion of the wrist bones are fused.
Proximal Row Corpectomy
A procedure that addresses the arthritic articulation by removing the proximal row of wrist bones.
Wrist Pain Limiting Your Grip?
The decision regarding nonoperative versus operative treatment is complex. An evaluation can help you understand which path is right for your wrist.
Request an AppointmentA Complex Decision
The decision regarding nonoperative versus operative treatment is complex and should be discussed with your treating physician.
Outcomes after Hand Surgery treatments vary and risks and benefits should be discussed in detail with your treating physician. Nonoperative treatment also carries risks and benefits which should be discussed with your treating physician.
Common Questions
Scapholunate Ligament Injury FAQs
What does the scapholunate ligament do?+
The scapholunate ligament stabilizes the scaphoid and lunate bone to one another in the wrist. This ligament has a dorsal portion, a membranous portion, and a volar portion.
How do scapholunate ligament injuries happen?+
Injuries may occur to this ligament during sports activities or falls. Occasionally, an injury may be associated with fractures or dislocations of the wrist.
Are all scapholunate injuries treated the same way?+
No. Mild sprains may be responsive to conservative treatment, while acute complete tears, chronic complete injuries, and injuries with associated arthritis each call for different treatment strategies. The decision regarding nonoperative versus operative treatment is complex and should be discussed with your treating physician.
What conservative treatments may help?+
Mild sprains of the scapholunate ligament may be responsive to conservative treatment including over-the-counter medication, splinting, and/or a supervised therapeutic exercise program. When arthritis develops, splinting, over-the-counter medications, and/or cortisone injection into the wrist joint may assist localized symptoms.
What is SLAC arthritis?+
When arthritis and associated symptoms occur with a scapholunate ligament injury, your physician may discuss a condition called SLAC (scapholunate advanced collapse arthropathy).
What surgical options exist when arthritis develops?+
In cases of arthritis where conservative treatment does not alleviate symptoms, surgical options include treatments such as scaphoid excision and partial wrist fusion (arthrodesis) or proximal row corpectomy.
A wrist injury that does not improve may also involve a wrist fracture. Read about the difference.
Precision Hand and Orthopedic Surgery
Wrist Pain That Hasn't Settled?
If wrist pain is persisting after a fall or sports injury, an evaluation with Tanay Amin, MD, FAAOS can help determine whether the scapholunate ligament is involved and which treatment options are appropriate for you.
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Disclaimer: This information is not intended to convey, substitute or supplant any medical advice. To establish a treating relationship, please schedule and complete your visits with a licensed physician.
Copyright 12/10/2021 Tanay Amin, MD. Do not copy, distribute, or publish this article. Please contact Precision Hand and Orthopedic Surgery PLLC with regards to any inquiries or corrections.