The role of arthroscopy in the treatment of scapholunate instability

Diagnosis of scapholunate instability is made using clinical provocative maneuvers such as the Watson test and a two-compartment arthrogram. The history of treatment options for this instability pattern is reviewed. A technique for arthroscopic treatment is described in which anatomic reduction and multiple pin fixation precipitate fibrous ankylosis to stabilize the joint. Best results were seen in patients with less than 3 months' symptom duration and less than 3-mm side-to-side gap difference. This treatment offers less loss of motion and minimal surgical surgical trauma to the wrist than other techniques currently in use.