Scapholunate Fixation

If you may need a scapholunate fixation, please Schedule an appointment with one of our orthopedic specialists as soon as possible.

What Is Scapholunate Fixation?

Scapholunate fixation refers to a surgical procedure that stabilizes the connection between the scaphoid and lunate bones in the wrist after ligament injury or severe instability. Surgeons place screws, pins, anchors, or other fixation devices across the joint to hold the bones in proper alignment and support ligament healing.

Doctors commonly recommend scapholunate fixation after trauma, chronic wrist instability, or ligament rupture that causes pain, weakness, or abnormal motion. The procedure aims to restore wrist mechanics, reduce symptoms, and help preserve long-term joint function while surrounding tissues recover.

Causes of Scapholunate Ligament Injury

Scapholunate injuries mostly result from trauma or repetitive stress. Common causes include:

  • Falls and Sports Injuries: Falling onto an outstretched hand (FOOSH) or a direct wrist blow can damage the ligament.
  • Degenerative Conditions: Osteoarthritis or rheumatoid arthritis can weaken the scapholunate ligament, reducing joint stability.
  • Repetitive Motion: Activities that involve manual labor or high-impact sports can stress the scapholunate joint and damage the ligament.

Symptoms of Scapholunate Injury

Scapholunate injury symptoms include:

  • Wrist Pain: Persistent pain, especially on the thumb side, worsens with gripping, twisting, or heavy use.
  • Swelling: Swelling around the wrist joint, especially after the injury.
  • Instability and Weakness: A feeling of instability or weakness, making daily tasks harder.
  • Deformity: Severe cases may show abnormal positioning or a visible gap between the scaphoid and lunate bones.

Diagnosis for Scapholunate Injury

Specialists diagnose a scapholunate injury through a combination of patient history, physical examination, and imaging studies. Clinicians ask about wrist pain, swelling, weakness, clicking, or previous trauma, then evaluate tenderness over the scapholunate interval and assess wrist motion and stability with specialized examination maneuvers.

Providers confirm the diagnosis with imaging tests such as wrist X-rays, stress radiographs, magnetic resonance imaging (MRI), or wrist arthroscopy. Radiologists and surgeons review these studies for ligament damage, abnormal spacing between the scaphoid and lunate bones, and signs of carpal instability. Arthroscopy often provides the most detailed assessment and allows direct visualization of ligament injury.

Scapholunate Fixation Surgery

Scapholunate fixation stabilizes the scapholunate joint and restores wrist function. Surgeons recommend the procedure when conservative methods, like bracing or physical therapy, fail, or when significant instability or ligament damage occurs.

The surgery generally includes these steps:

  • Incision: A small incision on the back of the wrist accesses the scapholunate joint.
  • Ligament Repair or Reconstruction: The surgeon repairs or reconstructs the torn ligament using tendon grafts or synthetic material.
  • Fixation: Surgeons stabilize the scaphoid and lunate bones with screws, pins, or plates during healing.
  • Closure: The incision is closed, and the wrist is placed in a splint or cast to promote healing.

Recovery for Scapholunate Fixation

After surgery, the wrist remains immobilized for several weeks to allow healing. Pain and swelling can be managed with ice and medication. Once healing progresses, physical therapy helps restore range of motion, strengthen wrist muscles, and improve grip. Patients gradually return to normal activities, though full recovery can take several months.

Scapholunate fixation surgery significantly reduces pain, improves wrist stability, and restores function. The outcome depends on the injury’s severity, surgical success, and adherence to rehabilitation. Surgery often prevents long-term complications like arthritis or chronic instability, common in untreated scapholunate injuries.

If you would like to speak to an Orthopedic Specialist, give us a call at 817-697-4038, or contact us over the web. Tele-medicine appointments are also available.