Scapholunate Ligament Injury, Wrist Arthritis/SLAC Arthritis

The scapholunate ligament stabilizes the scaphoid and lunate bone to one another in the wrist. This ligament has a dorsal portion, a membranous portion, and a volar portion. Injuries may occur to this ligament during sports activities or falls. Occasionally, an injury may be associated with fractures or dislocations of the wrist. Mild sprains of the scapholunate ligament may be responsive to conservative treatment including over-the-counter medication, splinting, and/or a supervised therapeutic exercise program. When pain persists despite conservative treatment, advanced imaging with MRI may be considered. This decision should be discussed with your treating physician.

In some patients with partial scapholunate ligament injuries, surgical wrist arthroscopy helps to further characterize the injury and assists with further treatment decisions. Acute complete tears of the scapholunate ligament are commonly repaired with the assistance of a suture anchor. In cases without arthritis and a complete chronic scapholunate ligament injury, ligamentous
reconstructive options may be considered. In one reconstructive technique, a portion of the tendon is taken from your forearm and passed through a tunnel drilled inside the scaphoid bone. This tunneled portion of the tendon is then connected to the lunate with a suture anchor. When arthritis and associated symptoms occur with a scapholunate ligament injury, your physician may discuss a condition called SLAC (scapholunate advanced collapse arthropathy).

When arthritis develops, splinting, over-the-counter medications, and/or cortisone injection into the wrist joint may assist localized symptoms. In cases of arthritis where conservative treatment does not alleviate symptoms, surgical options include treatments such as scaphoid excision and partial wrist fusion (arthrodesis) or proximal row corpectomy.
The decision regarding nonoperative versus operative treatment is complex and should be discussed with your treating physician. Outcomes after Hand Surgery treatments vary and risks and benefits should be discussed in detail with
your treating physician. Nonoperative treatment also carries risks and benefits which should be discussed with your treating physician.

Disclaimer: This information is not intended to covey, substitute or supplant any medical advice. To establish a treating relationship, please schedule and complete your visits with a licensed physician.

Copyright 12/10/2021 Tanay Amin, MD
Do not copy, distribute, or publish this article. Please contact Precision Hand and Orthopedic Surgery PLLC with regards to any inquiries or corrections.