Research Article| Volume 1, ISSUE 1, P45-60, February 2001

Scapholunate instability

  • Scott W Wolfe
    Address reprint requests to Scott W. Wolfe, MD, The Hospital for Special Surgery, 535 E. 70th St, New York, NY 10021
    Vilar Center for Research of the Hand and Upper Extremity, The Hospital for Special Surgery, Cornell University School of Medicine, New-York, NY
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      Injuries to the scapholunate joint are the most frequent cause of carpal instability and account for a considerable degree of wrist dysfunction and lost time from work and activities. The complex arrangement and kinematics of the 2 rows of carpal bones allows for an enormous degree of physiologic motion, and a hierarchy of primary and secondary ligaments serve to balance an inherently unstable structure. Although insufficient to cause abnormal carpal posture or collapse on static radiographs, an isolated injury to the scapholunate interosseous ligament may be the harbinger of a relentless progression to abnormal joint mechanics, cartilage wear, and degenerative change. Once disrupted, ligament repair methods and reconstructive options seldom serve to restore this delicately balanced design. Treatment options are predicated on the stage of injury, degree of secondary ligamentous damage, and arthritic change. Copyright © 2001 by the American Society for Surgery of the Hand
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      Further reading

        • Weiss AP
        Scapholunate ligament reconstruction using a bone-retinaculum-bone autograft.
        J Hand Surg {Am}. 1998; 23A: 205-215