[Arthroscopic treatment of scapholunate injuries : Diagnosis, classification, and the 4R algorithm]

Lesions of the scapholunate ligament are among the most common causes of carpal instability and may progress to scapholunate advanced collapse with progressive wrist osteoarthritis if left untreated. This review presents current arthroscopic treatment options in a structured manner and places them in the context of anatomy, pathomechanics, classification systems, and diagnostics. Wrist arthroscopy is the diagnostic gold standard and enables stage-appropriate treatment. According to the 4R algorithm acute refixations, capsuloligamentous reinforcement techniques, reconstructive procedures using tendon grafts, and arthroscopic salvage options for advanced degeneration are discussed. Arthroscopy and open surgery are complementary components of a continuous therapeutic strategy.