Scapholunate Ligament Tear
What is a Scapholunate Ligament Tear
The Scapholunate (SL) Ligament connects the scaphoid and lunate together. These two small wrist bones are very important in allowing the wrist to move smoothly. The movement of the scaphoid and lunate is coordinated by the SL ligament that attaches them. The SL Ligament may sustain a partial or complete tear. In a partial tear, some of the ligament is still functional and holding the bones together. A complete tear causes the scaphoid and lunate to lose direct connection and they no longer move together. This has important implications for instability of these two bones and the entire wrist.
Symptoms of Scapholunate Ligament Tear
When the SL Ligament is torn, pain and swelling commonly occur. Trying to move the wrist may be difficult and painful. In a complete SL tear, the wrist may “click” when moved due to the abnormal motion of the bones or the torn ligament getting caught between the bones.
Common Causes of Scapholunate Ligament Tear
A fall onto a hyper-extended wrist, such as in skiing, snowboarding, football, basketball, can cause a Scapholunate Ligament Tear. Often, the wrist injury may just “feel like a sprain” and the pain and swelling may subside over several weeks. However, if the SL Ligament was torn, pain with certain wrist positions and a feeling of weakness/instability can persist.
Diagnosing Scapholunate Ligament Tear
Speaking with you to understand how the wrist was injured carefully examining your wrist are essential. Particular exam tests can localize the injured structure. An x-ray will provide information about possible fractures and dislocation, in addition to the alignment of the wrist bones. An MRI may be helpful if there is concern for a complete tear or additional ligament injuries.
Treatment Options for Scapholunate Ligament Tear
A painful partial Scapholunate Ligament Tear without instability of the wrist bones can be treated with splinting or arthroscopic debridement. The goal of treatment for partial tears is to allow inflammation to resolve and eliminate loose tissue that can get caught between wrist bones and generate pain. A complete, or nearly complete, Scapholunate Ligament Tear initiates a path towards wrist degeneration that should be stopped as early as possible. Consequently, an acute complete SL tear can be repaired with arthroscopically-assisted surgery. Chronic complete SL tears may benefit from reconstruction of the ligament, screw fixation, or limited wrist fusion (arthrodesis).
A Scapholunate Ligament Tear benefits from accurate diagnosis and timely treatment. Call Dr. Pruzansky at 212-249-8700 to schedule an appointment and maintain wrist stability.
View of reconstructed scapholunate ligament involving anchors in the lunate and scaphoid holding the graft in place.
Wrist motion after reconstructing the scapholunate ligament demonstrating stability of the bones.
Video description: The soft bulging tissue above between the lunate, left, and scaphoid, right, represent a partial tear of the scapholunate interosseous ligament. The shaver is used to trim and smooth the surface of the tear. The fractured articular surface of the radius is below.