Treatment of scapholunate ligament injury: current concepts

Injuries to the scapholunate joint are the most common cause of carpal instability. An isolated injury to the scapholunate ligament may progress to abnormal joint mechanics and degenerative cartilage changes. Treatment for scapholunate instability is aimed at arresting the degenerative process by restoring ligament continuity and normalising carpal kinematics. Early arthroscopic diagnosis of scapholunate injury is mandatory for establishing the prognosis of the injury, as a proper ligament repair is recommended within four to six weeks after trauma. In this review, anatomy, diagnosis and treatment of scapholunate ligament injury and carpal instability are discussed. Recommendations for treatment based on the stage and classification of injury and the degree of instability and arthritic changes are proposed.