Scapholunate Ligament Injury

A scapholunate ligament injury involves damage to one of the most important stabilising ligaments in the wrist, which connects two small bones called the scaphoid and lunate.

This ligament plays a key role in maintaining normal wrist movement and alignment. When it is injured, the bones can move abnormally, leading to pain, weakness and instability.

The injury may occur suddenly following a fall onto an outstretched hand, or develop over time due to repetitive strain.

If left untreated, the condition can lead to progressive wear of the wrist joint (arthritis).

Treatment depends on the severity of the injury and how long it has been present.

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Diagnosis is based on clinical assessment and imaging.

Investigations may include:

• X-rays to assess bone alignment
• MRI scan to evaluate the ligament
• CT scan or specialised imaging in some cases
• Wrist arthroscopy, which allows direct visualisation of the ligament

These help confirm the diagnosis and guide treatment.

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Treatment depends on the severity of symptoms and the underlying cause.

Non-surgical treatment may include:

• Activity modification
• Wrist splinting
• Anti-inflammatory medication where appropriate
• Hand therapy

If symptoms persist, surgical treatment may be considered. Options may include:

• Arthroscopy to assess and treat damage within the wrist
• Procedures to reduce pressure across the joint, such as shortening of the ulna

The aim of treatment is to relieve pain and restore function.

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Surgical treatment varies depending on the severity and timing of the injury.

Procedures may involve repairing or reconstructing the ligament and stabilising the wrist using temporary fixation.

In long-standing cases, different procedures may be required to address joint damage

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Recovery depends on the type of treatment performed.

Recovery typically includes:

• A period of immobilisation in a splint or cast
• Gradual rehabilitation and strengthening
• Hand therapy to restore movement and function

Full recovery may take several months.

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As with any surgical procedure, there are potential risks, although these are uncommon.

Possible complications include:

• Infection (around 1%), usually treated with antibiotics
• Swelling or stiffness, which may take time to settle
• Scar sensitivity
• Nerve irritation or injury (rare)
• Ongoing pain or reduced wrist movement
• Failure of ligament healing or persistent instability
• Progression to wrist arthritis over time

Very rarely, a condition known as complex regional pain syndrome (CRPS) can occur, leading to prolonged pain and sensitivity

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You should seek medical advice if you have ongoing wrist pain following an injury, particularly if it is associated with weakness, clicking or a feeling that the wrist is not stable.

Early diagnosis is important, as untreated injuries can lead to long-term joint damage.

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