Treatment of scapholunate ligament injury

The scapholunate (SL) ligament (SLL) is the most commonly injured carpal ligament.1 The SLL is C-shaped and has three structurally distinct parts: volar; membranous; and dorsal (Fig. 1).2 The dorsal part of the SLL is the strongest and the primary stabiliser of the SL joint and can resist forces of up to 260 N.3 The avascular proximal membranous portion does not provide any significant laxity restraint (63 N), while the volar part of the SLL (118 N) plays an important role in terms of rotational stability.4,5 The dorsal part of the SLL measures 2 mm to 3 mm in thickness and is in the range of 2 mm to 5 mm in length. The vascular supply to the scaphoid and SLL is delicate. The main vascular contribution comes from the radial artery. Extra-osseous vessels enter the dorsal ridge of the scaphoid and supply two-thirds of the bone. It also appears that the radio-scapholunate (RSL) ligament provides a vascular supply directed at the SLL complex.