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What Is Scapholunate Ligament Repair?

Scapholunate ligament repair is wrist surgery used to restore the ligament that connects the scaphoid and lunate bones. This ligament is a major stabilizer that helps the two carpal bones move together in proper alignment. Direct repair is most suitable for selected acute or relatively recent tears when the ligament tissue can still be reattached. Chronic or irreparable injuries can require ligament reconstruction or another wrist-stabilizing procedure instead.

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What Is Scapholunate Ligament Repair?

Scapholunate ligament repair is wrist surgery used to restore the ligament that connects the scaphoid and lunate bones. This ligament is a major stabilizer that helps the two carpal bones move together in proper alignment. Direct repair is most suitable for selected acute or relatively recent tears when the ligament tissue can still be reattached. Chronic or irreparable injuries can require ligament reconstruction or another wrist-stabilizing procedure instead.

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Why Is Scapholunate Ligament Repair Performed?

Surgery is considered when a complete scapholunate ligament tear causes painful instability, widening between the scaphoid and lunate, or abnormal carpal alignment. Acute injuries are more likely to be directly repairable before the ligament retracts or degenerates. Persistent instability can alter wrist mechanics and contribute to progressive scapholunate advanced collapse arthritis over time. The treatment choice depends on injury age, ligament quality, carpal alignment, cartilage condition, and whether instability can still be reduced.

How Is Scapholunate Ligament Repair Performed?

The surgeon evaluates the scapholunate joint through an open or arthroscopic-assisted approach and restores the scaphoid and lunate to their proper relationship. Repairable ligament tissue is reattached to bone with sutures or suture anchors. Temporary Kirschner wires can be placed across the carpal bones to protect the repair while the ligament heals. A dorsal capsulodesis or another reinforcing procedure can be added when the surgeon wants extra support for the repaired ligament.

What Is Recovery Like After Scapholunate Ligament Repair?

The wrist is immobilized in a cast or splint during early ligament healing, and temporary pins can remain in place for several weeks. Hand therapy begins after the surgeon determines that the repair is sufficiently protected and any temporary fixation can be removed. Motion is restored gradually before strengthening and heavier gripping are introduced. Recovery commonly takes several months, and some loss of wrist motion or grip strength can remain.

What Are the Risks and Complications?

Possible complications include infection, stiffness, painful scarring, nerve irritation, pin-site problems, and loss of wrist motion. The repaired ligament can stretch or fail, allowing recurrent scapholunate widening or instability. Persistent malalignment can lead to progressive cartilage wear and scapholunate advanced collapse arthritis. Additional reconstruction, partial wrist fusion, proximal row carpectomy, or another salvage procedure can be needed if instability or arthritis progresses.

Frequently Asked Questions About Scapholunate Ligament Repair

Is scapholunate ligament repair the same as reconstruction?

No. Repair reattaches usable native ligament tissue, while reconstruction uses a tendon graft or another technique when the original ligament cannot be repaired reliably.

Are pins used after scapholunate ligament repair?

Temporary Kirschner wires are commonly used to hold the scaphoid and lunate in position while the repaired ligament heals. The exact fixation method varies.

Why is early treatment important for a scapholunate tear?

Recent tears are more likely to have ligament tissue that can be directly repaired. Chronic injuries can develop retraction, poor tissue quality, fixed malalignment, or arthritis.

Can wrist arthritis develop after scapholunate ligament repair?

Yes. Arthritis can still develop if instability persists or the wrist had substantial cartilage damage before surgery. Successful repair aims to reduce that risk by restoring alignment.

References

Treatment of scapholunate ligament injury: Current concepts. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC5644424/. Date Accessed August 13, 2026.

Scapholunate ligament injuries: a review of current concepts. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC3653000/. Date Accessed August 13, 2026.

Current Role of Open Reconstruction of the Scapholunate Ligament. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC3699272/. Date Accessed August 13, 2026.

Outcomes of Acute Versus Subacute Scapholunate Ligament Repair. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC9005375/. Date Accessed August 13, 2026.

Arthritis development following untreated scapholunate ligament injury. PubMed. https://pubmed.ncbi.nlm.nih.gov/20447356/. Date Accessed August 13, 2026.