Acute and chronic scapholunate ligament instability

Injury to the scapholunate junction and ensuing carpal instability is a potentially debilitating condition affecting all ages but particularly occurring in young active individuals. The natural history of scapholunate instability is poorly understood and the link between injury and progression to advanced degeneration of carpal bones is complex. Successful surgical management of acute scapholunate instability relies on an early detection because chronic instability presents its own unique challenges. In this article we will discuss the complex anatomy, biomechanics and pathomechanics of scapholunate instability and review the current concepts of management. We have also proposed a classification system to group the surgical management options of chronic instability.