What is a scapholunate ligament injury?

The scapholunate joint is a small joint between two carpal bones at the wrist crease, namely the scaphoid and lunate bones. The scapholunate joint is very important for the stability of the wrist joint. It is often injured during sport, for example, if you fall heavily onto your hand. It can also be injured through chronic overuse, for example, for those who are involved in manual work or lift heavy weights in the gym. It causes localised pain at the wrist, which is often made worse with gripping and weight bearing through the hand, such as during a press-up.

Obtaining the correct diagnosis is essential with scapholunate ligament injuries as a delay or missed diagnosis can result in chronic wrist pain and inability to weight bear through the wrist. Chronic scapholunate ligament injuries can also lead to osteoarthritis. Diagnosis is made using clinical assessment and diagnostic ultrasound. An MRI scan may be required depending on the mechanism and extent of the injury on ultrasound.

Treatment will depend on the severity of the ligament injury. Non-surgical treatment involves physiotherapy, including activity modification, splinting, exercise, and manual therapy. A referral to an orthopaedic surgeon may be required. If the pain does not improve and the ligament injury is a partial tear (not a full tear), then an ultrasound guided steroid injection can be carried out.

What are the symptoms of a scapholunate ligament injury?

The symptoms of scapholunate ligament injury are:

Pain and swelling at the wrist joint
Pain aggravated by weight bearing, for example during a press up
Wrist instability and weakness

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