Scapholunate Ligament Injuries

The scapholunate ligament is a crucial anchor between the scaphoid and the lunate bones and ensures they move synchronously. It is critical to the wrist articulation as the scaphoid and lunate form the crux of the proximal carpal row on which the distal carpal row rests.

An injury such as a fall onto the wrist can either fracture the bones or sever the ligament. Up to one in 5 distal radius fractures have an associated scapholunate ligament injury. If this torn ligament is not repaired or reconstructed timeously, then the wrist begins to degenerate in a predictable manner, resulting in the so-called SLAC (Scapholunate Advanced Collapse) wrist.

Patients commonly present many months following a badly sprained wrist, with some persistent intermittent discomfort in the wrist. There may be a myriad of symptoms from sharp stabbing pains to stiffness, swelling, clunking, weakness or the feeling of an unstable wrist.

  • Management

Management of this condition is surgical, in order to prevent deterioration of the wrist. The torn ligament needs to be repaired (if there is enough remaining) and augmented, or it needs to be reconstructed.

There are numerous techniques described to address this problem. The principle is to use a donor tendon or tightrope to augment the ligament repair, and on occasion wires are inserted to hold the bones in place for 6 weeks (these are then later removed)

Patience is the key in rehabilitation of these injuries, as the ligament takes months to repair and regain strength. The key to successful management of this condition is to restore normal wrist geometry so that it may move synchronously again.

Conditions Managed

Contact us anytime

Visit us in person

Claremont Medical Village
2nd floor, Suite 203, Library Square, Claremont Medical Village, Wilderness Road, Claremont, Cape Town, 7708

Advanced Harbour Bay Surgical Centre
Sessional Room, Cnr of Main and Dido Valley Road, Simon’s Town, Cape Town, 7975

Sports Science Orthopaedic Clinic
Room 1, Sports Science Orthopaedic Clinic, Sports Science Institute, Boundary Road, Newlands, 7700

Copyright by Dr Neil Kruger 2020. All rights reserved.