The scapholunate ligament in the wrist is commonly injured which is responsible for connecting the scaphoid to the lunate. Generally, the scaphoid and lunate move as one since they are connected tightly by the scapholunate ligament. Once a scapholunate ligament tear takes place, the scaphoid bones flex forward while the lunate is bent backwards which results to a gap in between the bones.
Close look on a scapholunate ligament tear
A scapholunate ligament tear can range from a minor sprain to a full tear along with other ripped ligaments. It can also be escorted by other injuries such as a fractured scaphoid or dislocation of the lunate. The injury can be categorized as follows:
- Predynamic or occult – this is the mildest form of tear characterized as a partial tear in the ligament.
- Dynamic – ligament is fully torn or stretched to a point where it could not function normally. There is minimal injury to the adjacent ligaments.
- Static – ligament is fully torn and some of the neighboring ligaments are also damaged
- Scapholunate advanced collapse – ligament is fully torn and injury has been present for an extended period which results to arthritis or there is proof of cartilage damage
The injury can be categorized based on the time the injury started – acute (below 4 weeks), sub-acute (4 weeks up to 6 months) and chronic (more than 6 months).
The management without surgery might be suitable for a predynamic injury or a minor sprain on the scapholunate ligament without any changes on the X-ray.
The treatment for a scapholunate ligament tear involves the following:
- Brace or cast worn for 2-6 weeks
- Reducing the level of activity responsible for the pain particularly those that involve tight gripping or pushing
- Anti-inflammatory medications
- A removable brace can be utilized for activities once gradual strengthening and stretching exercise are added.
Resuming sports might depend on the severity of the symptoms and the type of sport the individual engages in.
If these measures are not effective, surgery that is performed arthroscopically might be a possible option. Depending on the findings during arthroscopy, the ligament might be debrided or pins are placed with a cast.
More Information / Disclaimer
The information posted on this page on scapholunate ligament tear is for learning purposes only. Learn to recognize and manage ligament injuries including a scapholunate ligament tear by taking a standard first aid course with Vancouver First Aid.