Lunotriquetral Instability: Diagnosis, Management, and Current Concept Review

Lunotriquetral ligament injuries are infrequent and less well understood than the more commonly injured scapholunate ligament and represent a continuum of injuries from degenerative tears to total dissociation. Diagnosis can be elusive because only severe injuries with associated extrinsic ligament injury result in visible radiographic changes. The entire spectrum of injury can cause disabling pain and wrist dysfunction. An understanding of carpal anatomy and biomechanics is necessary for adequate care of these patients. History and physical examination are the cornerstones for diagnosis. Various patient factors, such as injury severity, degree of instability, and physical demands, determine treatment options. Options included steroid injections with immobilization, arthroscopic débridement, ligament repair, ligament reconstruction, intercarpal arthrodesis, and ulnar shortening osteotomy. Diagnostic and surgical techniques have slowly improved outcomes of this condition over the past two decades.