Digital Nerve Laceration

Thick bands of tissue called ligaments connect bones in the human body, including the eight bones of the wrist joint. The ligament most commonly impacted by wrist injuries is known as the scapholunate ligament.

If your wrist has been overused or injured and you are experiencing ongoing pain, stiffness, swelling, or loss of grip strength in the hand, a scapholunate ligament tear may be the culprit. Learn more below about this injury’s causes, diagnosis, treatment, and recovery:

What Is a Scapholunate Ligament Tear?

A scapholunate ligament tear is a tear in the ligament that connects the wrist joint’s scaphoid and lunate bones. Located in the center of the wrist, the scapholunate ligament allows for synchronous, stable movement. When it is disrupted, instability and pain can result and may eventually lead to arthritis in the wrist joint.

The most common cause of scapholunate ligament tears is a fall onto the hand, but any event that bends the wrist backward or puts an unusual amount of stress on it can result in this type of injury. Less commonly, scapholunate ligament tears can result from the ligament stretching out over time, often in connection with repeated strains, overuse, age, or other conditions such as chronic gout.

A scapholunate ligament tear may be complete or partial. Partial tears can often be treated non-surgically, while complete tears may require surgical intervention.

Recognizing the Symptoms

The symptoms of a scapholunate ligament injury may vary, but can include the following:

• Wrist pain
• Wrist instability
• Swelling and/or bruising
• Stiffness
• Reduced grip strength
• Painful popping associated with movement
• Pain after use (most often associated with chronic injuries)

Diagnosis: What To Expect

Diagnosis of a scapholunate ligament tear is typically made through a clinical examination followed by X-rays. An X-ray taken while the affected hand is clenched or gripping may reveal a widened gap between the scaphoid bone and lunate bone if a scapholunate ligament tear has occurred. Sometimes, an MRI scan may also be helpful in diagnosing scapholunate ligament injuries.

Treatment Options: Non-Surgical and Surgical

If the scapholunate ligament is sprained but has not sustained a complete tear, conservative treatment with rest and bracing may be effective. In cases where it has been completely torn through, surgical repair or reconstruction may be considered.

There are many ways to address these issues surgically.  Sometimes, you doctor will assess the ligament with a scope (wrist arthroscopy) to see it and determine how bad the tear is and look for arthritis.  Then, if it’s fixable, the ligament could be repaired with sutures and suture anchors.  The wrist bones will often be pinned for 2-3 months to protect the healing ligament.

Scapholunate ligament reconstruction is a surgical procedure toe make a new ligament if your ligament can’t be fixed.  Surgery is often carried out using bone anchors and a tendon autograft. This type of surgery can help to effectively stabilize the wrist and reduce the risk of future post-traumatic arthritis in the joint.

Risks and Recovery

For mild to moderate scapholunate ligament injuries that do not require surgery, the recommended amount of immobilization time may vary but will usually range from about 2-6 weeks. Patients who undergo surgical ligament repair will usually be strictly immobilized for at least 4 weeks post-surgery, at which point they will begin therapy to regain range of motion and strength in the wrist.

Surgical scapholunate ligament tear treatment is not considered high risk, but like all surgeries, it comes with risks such as infection, scarring, and the possibility of complications. Speak directly with your surgeon for a more in-depth discussion of potential surgical outcomes.

When To Consult a Doctor

If you have acute or ongoing pain in your wrist, you should see a doctor to receive a conclusive diagnosis and move forward with an appropriate treatment plan. Ignoring a wrist injury can make healing more difficult in the long run.

Don’t Wait, Get Checked Today

The team of world-class surgeons at Modern Orthopaedics of New Jersey has expertise in wrist injuries and treatments of all kinds. Contact us directly to make an appointment and begin the journey to complete wrist recovery today!