A ligament is a thick band of tissue that connects two bones. There are numerous ligaments in the wrist, with the scapholunate ligament being the most frequently injured among them. This ligament is located in the center of the wrist, between the scaphoid and lunate bones. These two bones connect the wrist to the radius and contribute to the painless and full range of motion of the wrist.
There are various degrees of injury to the scapholunate ligament, ranging from mild stretching to complete Rupture The categories are distinguished as follows:
1tear Grade: The ligament is slightly stretched but maintains joint stability.
2tear Grade: The ligament exhibits stretching and partial tearing of its fibers.
3tear Grade: The ligament is completely ruptured and no longer provides stability to the joint.
Causes of scapholunate ligament rupture
The most common cause of scapholunate ligament rupture is the application of excessive force on the wrist that exceeds its tolerance limits. In addition to excessive pressure, ligament rupture may also result from:
- Falling onto the hand or wrist
- Repetitive strain, e.g., due to sports activities or occupational tasks
- Hyperextension of the wrist or positioning it in an unusual angle
- Degenerative changes due to aging
- Long-term inflammation
Symptoms of scapholunate ligament rupture
Symptoms associated with scapholunate ligament rupture include:
- Pain, which may worsen with wrist movement or bending
- Swelling in the affected region.
- Limited range of motion of the knee.
- Bruising
- Pain and swelling on the dorsal (back) side of the wrist
- A clicking or popping sensation
- Weakness in the wrist
Pain and swelling in the case of a scapholunate ligament rupture can occur immediately after the injury. However, symptoms may persist and even worsen over time. In some cases, symptoms may not become noticeable until years after the initial injury.For diagnosis, a clinical examination is essential, along with imaging studies such as X-rays and magnetic resonance imaging (MRI). Following confirmation, the physician determines the most appropriate treatment approach based on the severity of each case In general, scapholunate ligament rupture can be managed with:
- Rest to minimize stress on the affected joint.
- Cryotherapy
- Use of a splint or brace for immobilization
- Pharmacological therapy, typically nonsteroidal anti-inflammatory drugs (NSAIDs)
- Individualized physiotherapy program
- Surgical intervention may be required in severe cases or when conservative methods fail. Surgery is usually performed arthroscopically which is the most modern, rapid, and safe method for repairing the injury. In many cases, the patient can be discharged on the same day as the procedure.
A scapholunate ligament rupture does not heal on its own. If left untreated, it can lead to arthritis over time, as the carpal bones are no longer maintained in proper alignment. The primary goals of treatment are pain reduction and prevention of arthritis.
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