Scapholunate Ligament Injury Book Now

Scapholunate Ligament Injury

A ligament is a strong, fibrous band of tissue that links two bones together. The wrist comprises numerous ligaments, and when one is damaged, it results in a sprain. One of the most frequently injured ligaments in a wrist sprain is the scapholunate ligament located between the scaphoid and lunate bones at the centre of the wrist. This ligament plays a key role in guaranteeing smooth, pain-free wrist movement. Injuries to the scapholunate ligament can range from mild stretching to a complete tear, potentially leading to wrist instability and discomfort.

Signs and Symptoms

An injury to the scapholunate ligament often leads to wrist pain and swelling, particularly with specific movements. Common symptoms include:

  • Pain during the wrist backward bending
  • Bruising
  • Reduced range of motion
  • Gradual swelling and discomfort, normally on the back of the wrist
  • Popping or grinding sensations
  • Wrist weakness

Pain and swelling may occur immediately after the injury or develop progressively over time. In some cases, symptoms may not become noticeable until years following the initial injury.

Causes

Usually, scapholunate ligament tears when excessive stress is placed on the wrist. A widespread cause is falling onto an outstretched hand, especially when the wrist is forced backward or into an uncommon position. At times, the ligament may gradually weaken because of repetitive strain, age-related loosening, or prolonged inflammation. Chronic conditions such as gout can also contribute to ligament damage in the end.

Diagnosis

Diagnosing a scapholunate ligament injury can be challenging. Your GP will assess wrist movement, identify areas of pain and compare the affected wrist to the uninjured one.

X-rays are commonly used to evaluate wrist pain. While ligaments cannot be seen on X-rays, changes in bone spacing and alignment may indicate a ligament injury. The scapholunate ligament normally keeps the scaphoid and lunate bones together, but when it is damaged, these bones may separate, creating a visible gap.

An MRI may be used to confirm the diagnosis since it provides a clearer view of ligament damage. In some cases, a radiologist may administer dye into the joint before performing the MRI, a procedure known as an MR arthrogram, to better detect ligament tears. Additionally, some surgeons may recommend wrist arthroscopy. This minimally invasive procedure utilises a small camera to examine the ligaments directly inside the joint.

Treatment

A torn scapholunate ligament doesn’t repair on its own. Without treatment, this condition can eventually result in arthritis due to misalignment of the wrist bones. The treatment relieves pain and prevents arthritis. The doctor will recommend treatment options based on the severity of the injury and the duration since the injury occurred.

For a new scapholunate ligament injury, initial treatment focuses on pain management. This may involve:

  • Using a wrist splint or cast
  • Reducing activity and allowing the wrist to rest (which may take six or more weeks to improve)
  • Hand therapy if stiffness develops after immobilisation from a cast or splint
  • Cortisone injections and anti-inflammatory drugs for pain relief (though they do not correct bone alignment)

If these methods are ineffective, surgery may be necessary to mend or reconstruct the ligament and restore wrist stability. This can be performed through arthroscopy or open surgery. While surgery may result in some wrist stiffness, it often reduces pain by stabilising the joint.

Treatment options for chronic injuries:

For long-standing injuries, it may no longer be possible to realign the wrist bones or prevent arthritis. Treatment focuses on pain management and preserving function. Options may include wrist denervation—cutting certain wrist nerves to reduce pain.

Depending on the extent of arthritis, options may include bone removal or partial wrist fusion, where two bones are fused to limit movement and reduce pain.

The surgeon will help determine the most suitable approach based on your condition and lifestyle.

Conclusion

A scapholunate ligament injury can cause ongoing pain and instability if left untreated; this potentially leads to arthritis over time. Early diagnosis and the right treatment plan can be helpful in restoring function, lowering discomfort, and protecting long-term wrist health.

Book an appointment with a hand specialist right now for an expert evaluation and explore the best treatment options before symptoms worsen.