Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Aug 6:10:41-54.
doi: 10.2147/ORR.S129620. eCollection 2018.

Optimal management of scapholunate ligament injuries

Geoffrey Konopka  1 , Harvey Chim  2
Affiliations
Review

Optimal management of scapholunate ligament injuries

Geoffrey Konopka et al. Orthop Res Rev. .

Abstract

Scapholunate ligament (SLL) injuries are a common cause of wrist pain and instability. Treatment of SLL injuries requires intricate understanding of wrist anatomy and biomechanics. Mindful physical exam and appropriate diagnostic studies can orient the surgeon to the defined stage of injury. Review of the literature on each treatment by stage can prepare the upper extremity surgeon to provide the best evidence-based care. The optimal management of SLL injuries should result in a stable, painless wrist.

Keywords: SLAC wrist; carpal dissociation; carpal instability; scapholunate ligament; wrist instability; wrist trauma.

PubMed Disclaimer

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Wrist anatomy. Notes: (A) The bones of the wrist: trapezium (1), trapezoid (2), capitate (3), hamate (4), scaphoid (5), lunate (6), triquetrum (7), pisiform (8), radius (9), ulna (10), and the bases of the metacarpals (11). (B) The dorsal wrist ligaments: dorsalcapitohamate (12), dorsal capitotrapezoid (13), dorsal intercarpal ligament (14), radiotriquetral (15), dorsal lunotriquetral (16), dorsal scapholunate (17), and dorsolateralscaphotrapeziotrapezoid (18). (C) The palmar superficial wrist ligaments: transverse carpal ligament (19), radioscaphoid (20), scaphocapitate (21), radioscaphocapitate (22), long radiolunate (23), ulnocapitate (24), and pisohamate (25). (D) The palmar deep wrist ligaments: palmar capitotrapezoid (26), scaphocapitate (27), triquetral-hamate-capitate (28), palmar scapholunate (29), palmar lunotriquetral (30), short radiolunate (31), ulnolunate (32), ulnotriquetral (33), and palmar capitohamate (34).
Figure 2
Figure 2
Uninterrupted “Gilula Lines” 1, 2, and 3 in a wrist with normal alignment.
Figure 3
Figure 3
“Terry Thomas” sign on a wrist PA radiograph showing scapholunate diastasis.
Figure 4
Figure 4
The scapholunate angle is measured on a lateral radiograph of the wrist. Notes: The scaphoid line (S) is drawn tangential to the scaphoid along the palmar aspects of the distal and proximal poles of the bone. The lunate line (L) is drawn perpendicular to a line drawn tangential to the palmar and dorsal points of the lunate. The scapholunate angle is measured between the two lines.
See this image and copyright information in PMC

References

    1. Feipel V, Rooze M. The capsular ligaments of the wrist: morphology, morphometry and clinical applications. Surg Radiol Anat. 1999;21(3):175–180. - PubMed
    1. Berger RA. The ligaments of the wrist. A current overview of anatomy with considerations of their potential functions. Hand Clin. 1997;13(1):63–82. - PubMed
    1. Moojen TM, Snel JG, Ritt MJPF, Venema HW, Kauer JMG, Bos KE. In vivo analysis of carpal kinematics and comparative review of the literature. J Hand Surg Am. 2003;28(1):81–87. - PubMed
    1. Gupta A. Factors affecting the sagittal alignment of the lunate. J Hand Surg Eur Vol. 2007;32(2):155–159. - PubMed
    1. Ishikawa J, Cooney WP, Niebur G, An KN, Minami A, Kaneda K. The effects of wrist distraction on carpal kinematics. J Hand Surg Am. 1999;24(1):113–120. - PubMed