Best Treatments for Hand Ligament Injuries

Ligaments are tough pieces of connective tissue that join one bone to another. Ligaments are attached on either side of a joint, strengthening and stabilizing it by limiting excess motion of the bones. Injuries to ligaments are very common; in fact, what we call a sprain is actually an injury to the ligaments of the “sprained” joint. The hand is particularly susceptible to ligament injuries simply because it gets so much use and thus is exposed to many possibilities for injury. One common place for a hand ligament injury to occur is in the scapholunate ligament. This ligament connects the scaphoid and the lunate, two of the small carpal bones, which make up the wrist and base of the palm.

Dr. Steven J. Lee is a board-certified, double fellowship trained orthopedic surgeon in NYC with special expertise in the treatment of complex injuries and disorders of the hand and wrist. Here’s an overview of one common type of hand ligament injury and how it is treated.

 

What is a scapholunate ligament tear?

The scapholunate ligament is responsible for ensuring that the two bones – scaphoid and lunate – move in unison. This ensures smooth rotation of the wrist. When this ligament is torn, the scaphoid and lunate move in different directions, which results in pain and loss of strength when gripping.

 

What are the symptoms of a scapholunate ligament injury?

While hand ligament injuries are often obvious due to the local pain and swelling that accompanies them, the severity of such injuries is easy to misjudge. Symptoms vary depending on the severity of the injury, but commonly include pain on the thumb side of the wrist, swelling and/or bruising, loss of grip strength, and sometimes a snapping or popping in the wrist.

Like tendons, ligaments are made up of many tough fibers, and the severity of the injury depends on how many fibers are involved and how completely they are involved. Any number of ligament fibers may be injured, from one or two to all of them. They may only be inflamed or bruised, or they may be completely torn. When all of the fibers are torn, this is described as a complete scapholunate ligament tear.

 

What are the causes of a scapholunate ligament tear?

Scapholunate ligament tears are usually the result of an accident. A fall or sudden stress on the wrist – such as weight-bearing activities – can cause a ligament tear and separate the small bones of the inner wrist. This type of injury is common among athletes and is sometimes accompanied by a fracture.

 

What are the treatment options for a hand ligament injury?

Hand ligament injuries seldom need surgery unless a fracture has also occurred. In many cases, conservative treatments such as splinting or casting the injured wrist/hand and taking anti-inflammatory medications are sufficient.

When hand surgery to repair the torn ligament is necessary, it’s often done arthroscopically. Arthroscopic surgery for a scapholunate repair uses very small incisions and causes less trauma to the tissue than conventional surgery. Surgical repair may include debriding the torn ligament—which involves cleaning up the damaged ligament tissue so new, healthy tissue can grow—or, in severe cases, repairing the tear with sutures anchored to the bone. This may also necessitate realigning the bones and anchoring them in place with pins so they don’t pull the healing ligament apart. Surgical repairs may make several weeks in a cast or splint necessary in order to ensure the return of proper wrist function following surgery.

 

Where can I find treatment for my hand ligament injury in NYC?

Dr. Steven Lee is the Chief of Hand and Upper Extremity Surgery at Lenox Hill Hospital in NYC and has been consistently recognized as one of New York’s top orthopedic doctors by New York Magazine and Castle Connolly. If you are suffering from symptoms of a hand ligament injury and evaluating your treatment options, schedule a consultation with Dr. Lee today.

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Dr. Jose Rodriguez is no longer practicing at New York Orthopedics as of March 31, 2017. For a full list of our doctors, please visit this page.