Lunotriquetral instability: diagnosis and treatment

Abstract

Isolated injury of the lunotriquetral interosseous ligament complex and associated structures is less common and is poorly understood compared with the other proximal-row ligament injury, scapholunate dissociation. The spectrum of injuries ranges from isolated partial tears to frank dislocation, and from dynamic to static carpal instability. The diagnosis may be difficult to establish because of the many possible causes of ulnar-sided wrist pain and the often normal radiographic appearance. The mechanism of injury is variable and includes attrition by age, positive ulnar variance, and perilunate or reverse perilunate injury. Appropriate treatment requires assessment of the degree of instability and the chronicity of the injury. Options include corticosteroid injection, immobilization, ligament repair, ligament reconstruction with tendon grafts, limited intercarpal arthrodesis, and ulnar shortening.