The eight carpal bones of the wrist work together to ensure proper rotation and movement. Two of these bones are the lunate and the scaphoid, located in the middle of the wrist and the thumb side of the wrist, respectively. The scapholunate (SL) ligament, which is the most commonly injured ligament of the wrist, connects these bones. Following a scapholunate (SL) ligament tear or injury, patients in the Atlanta, GA area can come to Dr. Steven Bailey at The Hand Center at Crawford Plastic Surgery for treatment that relieves pain and restores wrist function.
What Is a Scapholunate (SL) Ligament Injury?
An SL ligament injury refers to any damage to the ligament that joins the lunate and scaphoid bones of the wrist. If the SL ligament is torn or damaged, it can cause the lunate and scaphoid bones to separate and move in different directions. This results in pain and various issues affecting the use of the wrist and hand.
Symptoms of Scapholunate (SL) Ligament Injuries
Some of the most common symptoms of scapholunate (SL) ligament injuries include:
- Wrist pain (typically on the thumb side)
- Swelling of the wrist
- Bruising around the wrist
- Loss of grip strength
- Snapping or popping sensations in the wrist
Causes of Scapholunate (SL) Ligament Injuries
SL ligament injuries can be caused by various kinds of physical trauma, including falls, sports injuries, vehicle accidents, and work accidents. SL ligament injuries may also be linked to injuries of the carpal bones, such as scaphoid fractures and lunate dislocation.
Types of Scapholunate (SL) Ligament Injuries
SL ligament injuries can be classified based on the nature of the injury and its severity.
- Predynamic SL Injury: The least severe SL injury, the ligament is just partially torn.
- Dynamic SL Injury: The SL ligament is completely torn or has been stretched in such a way that it can no longer function normally. A gap is present between the lunate and scaphoid bones.
- Static SL Injury: The SL ligament is completely torn and damage to other ligaments of the wrist may be detected. A gap is present between the lunate and scaphoid bones.
- Scapholunate Advanced Collapse (SLAC) Injury: The SL ligament has been completely torn for a long period of time, the lunate and scaphoid bones are separated, and other carpal bones are affected. Cartilage damage and wrist arthritis are often present.
Scapholunate (SL) Ligament Injury Diagnosis
When diagnosing SL ligament injuries, advanced imaging technology will be used as part of the medical exam. X-rays can help note the nature of the SL injury and if there are additional issues affecting the scaphoid or lunate bones. MRI scans can also be helpful in assessing the extent of the ligament damage.
We will discuss the nature of the patient's symptoms to determine when the SL ligament injury occurred and what may have caused it. These are important concerns when determining the proper treatment plan.
Treatment of Scapholunate (SL) Ligament Injuries
For less severe SL ligament injuries, the most common approach to treatment will involve the use of a splint or cast to stabilize the hand and wrist. This will help the ligament heal on its own. Patients can also take anti-inflammatory drugs in order to manage the pain and discomfort associated with the injury.
For serious SL ligament injuries, surgery may be recommended to repair the torn ligament. This will often involve removal of damaged tissue around the ligament so that it may repair on its own. For more serious SL ligament tears, pins or wires may be used to hold the scaphoid and lunate bones in place as the ligament heals. Ligament reconstruction may also be considered, which involves the use of some donor wrist tendon to rebuild the damaged SL ligament.
Recovery after Scapholunate (SL) Ligament Surgery
Following SL ligament surgery, patients will wear a splint or a cast to help stabilize the wrist. Patients will be asked to avoid strenuous physical activities to ensure proper healing. If used, surgical pins will be removed several weeks after the surgery. Once the cast is removed, patients will undergo physical therapy to restore wrist flexibility and strength.
Contact The Hand Center at Crawford Plastic Surgery to learn more about scapholunate (SL) ligament injuries and the treatment options available.