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Scapholunate Ligament Tear

The scapholunate ligament (SL) is located between two bones in the hand, the scaphoid and the lunate. These bones are located in the centre of the wrist, the SL ligament ensures that the two move together correctly allowing smooth rotation at the wrist. When the ligament is damaged the bones separate in opposing directions which results in a painful loss of grip, strength and movement of the wrist.

Symptoms

Symptoms of a SL ligament tear may include:

  • Loss of grip strength
  • Snapping or popping at the wrist
  • Bruising
  • Limited range of motion
  • Swelling
  • Pain in wrist on the thumb side
  • Pain when bending the wrist backwards

Causes

SL ligament tears are usually as a result of a fall or sudden weight bearing impact force. This injury is commonly found in athletes and it is not unusual for a fracture of the scaphoid to accompany the ligament tear. The main cause is from a fall on the hand or sudden weight bearing activities. The injury will be diagnosed by a medical specialist and most likely use an x-ray to rule in or out any secondary damage or complication such as a fracture.

Treatments

Non-surgical treatment options

A non-surgical approach will involve wearing a splint or cast for several weeks before beginning a physiotherapy rehabilitation programme to regain strength around the injured area and regain lost range of motion. The use of ice following injury is key to reducing swelling and aiding the natural healing process of the ligament. Using NSAIDs will help to reduce pain and swelling in the affected area. If none of these measures make a difference then steroid injections may be used.

Surgical approach

A surgical approach to this condition normally involves an arthroscopic procedure using small incision in the skin to repair the damaged ligament. The ligament may be debrided, this is a process of cleaning the end of the ligament so the healthy tissue can grow in an efficient way. Surgery normally involves plates and pins and sometimes realignment to ensure correct growth. Surgery requires several weeks post op in a cast and a rehabilitation programmed shortly after to ensure proper function returns to the wrist and hand.

Strand House, 169 Richmond Rd, Kingston upon Thames KT2 5DA 020 8546 6464