What is a Scapholunate Tear?

The scapholunate ligament plays a vital role in wrist stability. It connects two small bones in the wrist called the scaphoid and lunate. These bones must move together smoothly for the wrist to work properly. When the ligament is healthy, it keeps these bones aligned. However, if the ligament tears, it causes instability. This can lead to pain, weakness, and reduced wrist function. Left untreated, the injury may worsen and cause long-term damage such as arthritis. Understanding this injury is important for early treatment and recovery.

What is a Scapholunate Tear?

The wrist consists of several small bones held together by ligaments. Among these, the scapholunate ligament connects the scaphoid and lunate bones near the centre of the wrist. The scaphoid sits on the thumb side, while the lunate lies next to it in the middle of the wrist. This ligament ensures that these two bones move in sync during wrist movements. Without it, the bones can shift apart, causing abnormal wrist mechanics and pain. Knowing this anatomy helps to appreciate why a tear here is so disruptive.

Causes of Scapholunate Ligament Tears

Scapholunate tears happen for various reasons. The most common cause is trauma, especially a fall onto an outstretched hand. This type of impact puts sudden pressure on the wrist and can strain or tear the ligament. Repetitive strain from frequent wrist movements, often seen in athletes or manual workers, can also weaken the ligament over time. Aging and degeneration may contribute as well. Less commonly, conditions like chronic gout can lead to ligament damage. Understanding these causes can aid in prevention and early detection.

Types and Severity of Scapholunate Tears

Scapholunate tears vary in severity. They are commonly classified into four categories:

• Predynamic: A partial tear or stretch, the ligament remains mostly intact.
  
• Dynamic: A complete tear or severe stretch, often with mild injury to nearby ligaments.
  
• Static: A complete tear with damage to surrounding ligaments, visible as a gap between bones on X-rays.
  
• Scapholunate Advanced Collapse (SLAC): A chronic condition where untreated tears lead to arthritis and joint collapse.
  
  

Symptoms of a Scapholunate Tear

Signs of a scapholunate ligament tear can vary but often include:

• Pain on the thumb side of the wrist
  
• Swelling or bruising around the wrist
  
• Weak grip strength or difficulty holding objects
  
• Clicking, popping, or snapping sounds during wrist movement
  
• Stiffness and reduced range of motion
  
• Persistent discomfort after use, especially in chronic cases.
  
  

How is a Scapholunate Tear Diagnosed?

Doctors start diagnosis with a detailed history and physical exam. They may perform the Watson scaphoid shift test to check for ligament instability. Imaging is then used to confirm the injury. Standard X-rays can reveal gaps or misalignment between the scaphoid and lunate bones. Stress X-rays, taken while the wrist is bent or the fist clenched, may detect instability not visible in regular views. MRI scans can visualise soft tissue injuries, sometimes using injected dye (arthrogram) for clarity. When uncertainty remains, wrist arthroscopy allows direct inspection of the ligament.

Non-Surgical Treatment Options

Mild or partial scapholunate tears may heal without surgery. Treatments include:

• Immobilisation with a splint or cast for 2 to 6 weeks
  
• Rest and avoiding activities that worsen symptoms
  
• Anti-inflammatory medications to reduce pain and swelling
  
• Ice application and compression wraps following the P.R.I.C.E. method
  
• Gradual introduction of physical therapy to restore strength and motion
  
• Use of removable braces during activity as healing progresses
  
  

Surgical Treatment Options

When tears are complete or fail to improve with conservative care, surgery is considered. Surgical options include:

• Direct repair of the torn ligament using sutures and anchors
  
• Ligament reconstruction with tendon grafts to restore stability
  
• Pinning the scaphoid and lunate bones during healing to maintain alignment
  
• Partial wrist fusion or removal of damaged bones in advanced cases.
  
  

Recommended Supportive Braces for Wrist Injuries

If you’re dealing with wrist pain or healing from an injury like a scapholunate tear, having the right support can make a big difference. The Arthritis Wrist Support helps reduce swelling and soothe discomfort by providing gentle warmth and compression. When your thumb needs extra help, the Solid Thumb Support Splint offers solid stability while still allowing some movement. The TFCC Support Wrist Brace is designed specifically to ease pain on the outer side of the wrist and aid healing. For everyday comfort and protection, the UltraFlex Wrist Brace gives flexible support without limiting your motion. Wearing these braces can help you feel steadier, cut down pain, and get back to your routine sooner.

Recovery and Rehabilitation

Recovery depends on the injury's severity and treatment method. After surgery, the wrist is usually immobilised in a cast or splint for several weeks, often with pins in place. Once initial healing occurs, physical therapy begins to restore range of motion and strength. Strengthening exercises start with light weights and progress over months. Return to sport or heavy activities may take 5 to 6 months. Supportive braces may be recommended during recovery and early return to activity to protect the wrist.

Also read : What is a Distal Radius Fracture

Summary and Conclusion

The scapholunate ligament is crucial for wrist stability. Tears to this ligament can cause pain, weakness, and long-term joint problems. Early recognition of symptoms and timely diagnosis are essential. Treatment ranges from splints and physical therapy to surgery in severe cases. Rehabilitation is key to regaining wrist function. Ignoring this injury can result in arthritis and permanent damage. If you suspect a scapholunate tear, consult a specialist to protect your wrist health and maintain your quality of life.