Scapholunate Ligament Injury

What is a scapholunate ligament injury?

A scapholunate ligament injury involves the tearing or stretching of the ligament that connects the scaphoid to the lunate—two small carpal bones in the wrist. This ligament is essential for maintaining wrist stability and function, and its injury can lead to significant instability and pain. It is one of the most common causes of chronic wrist pain and, if not treated properly, can result in complications such as osteoarthritis.

Symptoms:
Symptoms of a scapholunate ligament injury include pain and swelling in the central area of the wrist, which worsens with physical activity or pressure. Patients may feel weakness or instability in the wrist, and in some cases, a “clicking” or “popping” sensation during wrist movements. Reduced grip strength or difficulty lifting objects may also be present, and the pain can radiate up the forearm.

Causes:
The most common causes of this injury include acute trauma, such as falls on an outstretched hand or direct impacts during sports activities. Repetitive movements or excessive strain can also contribute, particularly in athletes or people performing manual labor. In some cases, an improperly treated wrist fracture may lead to a scapholunate ligament injury.

Diagnosis:
Diagnosis is made through a thorough medical history and physical examination. The physician may perform specific wrist tests, such as the Watson test, to assess the stability of the ligament. X-rays can reveal a widening of the space between the scaphoid and lunate, while ultrasound and magnetic resonance imaging (MRI) are useful for visualizing the ligament injury and evaluating any associated damage.

Treatments:
Treatment of a scapholunate ligament injury depends on the severity and the time elapsed since the injury. For acute injuries, conservative management may include immobilization with a splint or cast for 6 to 8 weeks, along with anti-inflammatory medications to reduce pain and inflammation.

For chronic or more severe injuries, surgery may be required to repair or reconstruct the damaged ligament. Surgical options may involve ligament suturing, reconstruction using autologous tissue or grafts, and stabilization of the affected bones with Kirschner wires or screws. In some cases, wrist arthroscopy may be needed to assess and treat associated intra-articular injuries.

At Handclinic, under the direction of Dr. Marco Guidi, we use advanced technologies and a personalized approach to treat scapholunate ligament injuries. Our goal is to restore wrist stability and function, enabling our patients to return to daily life without pain and with full mobility. With timely and appropriate treatment, long-term complications can be prevented and quality of life can be significantly improved.