Scapholunate Ligament Injury
What is Scapholunate Ligament Injury?
The scapholunate ligament (SL) is one of the primary stabilising ligament between the scaphoid and lunate bones at the centre of the wrist. When this ligament is sprained or torn, the two bones lose their normal coordinated movement. SL injuries can lead to wrist instability, pain and - if left untreated - progressive arthritis of the wrist joint.
Scapholunate injuries range from minor sprains, to complete tears with significant carpal instability. They most commonly result from a fall onto an outstretched hand and are frequently missed on initial assessment, leading to delayed diagnosis. Early specialist input is critical: untreated scapholunate dissociation is a leading cause of long-term wrist dysfunction and wrist arthritis.
What causes Scapholunate Ligament Injury?
- Fall onto an outstretched hand: the most common mechanism, transmitting force through the wrist
- High-energy wrist trauma including sporting collisions, road traffic accidents and industrial injuries
- Repetitive loading of the wrist in manual workers or gymnasts over time
- Associated with distal radius fractures: scapholunate ligament injury is present in up to 30% of wrist fractures
Signs & symptoms
- Pain along the back of the wrist
- A clunking or clicking sensation with wrist movement, especially during activity
- Wrist swelling following acute injury
- Weakness of grip and reduced wrist range of motion
- A feeling of wrist instability or giving way during weight-bearing activities
How Hand Therapy can help
Ms Razo provides specialist assessment and evidence-based treatment for Scapholunate Ligament Injury. Following a thorough initial assessment, a personalised treatment plan will be developed to address your specific needs and goals.
In acute and partial injuries, immobilisation in a custom, thermoplastic orthosis protects the healing ligament and reduces pain. Ms Razo designs orthoses to immobilise the wrist while preserving functional hand use.
As healing progresses, a carefully supervised rehabilitation programme restores wrist range of movement and stability.
Scapholunate ligament repairs, reconstructions and arthroscopic procedures all require specialist post-operative rehabilitation. Ms Razo works alongside wrist surgeons to design and deliver rehabilitation programmes appropriate to the surgical technique. Doing so ensures optimal recovery of wrist stability and function.
Where scapholunate injury has led to early wrist arthritis or residual instability, Ms Razo provides ongoing management including splinting for provocative activities, adaptive equipment and joint protection strategies to maintain wrist function over the long term.
Frequently asked questions
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Partial scapholunate ligament injuries, where the ligament is sprained, can heal with immobilisation and rehabilitation. Complete tears with significant carpal instability are unlikely to heal without surgical intervention. The management approach depends on the degree of ligament disruption, the duration of the injury and the patient's activity demands.
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Scapholunate injuries can be subtle on plain X-rays, particularly in the acute phase when swelling may not yet have allowed the bones to separate. Dynamic or stress X-rays, MRI and diagnostic wrist arthroscopy are all used to confirm the diagnosis. If you have had a wrist sprain that has not settled with time, specialist assessment is strongly recommended.
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Untreated scapholunate dissociation leads to progressive carpal malalignment. Over years, this causes an established pattern of wrist arthritis known as SLAC wrist (scapholunate advanced collapse), which results in chronic pain and significantly reduced wrist function. Early diagnosis and treatment is strongly associated with better long-term outcomes.
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Recovery following surgical scapholunate repair typically takes a number of months. Wrist immobilisation post-operatively is followed by progressive rehabilitation. Full recovery of wrist and grip strength is guided by the individual's progress in rehabilitation.
Ready to take
the first step?
Book a consultation with Ms Razo and receive a thorough assessment, precise diagnosis and a personal treatment plan.