Scapholunate injury scenario: Graham works in the army and had a fall on an outstretched hand. Since then he has had pain while doing push-ups and has lost strength in his hand.
Graham may have sustained a scapholunate injury. The wrist consists of 8 carpal bones, 2 of them being the scaphoid and the lunate. The scapholunate ligament holds the scaphoid and lunate bone together.
There are many ligaments in the wrist but the scapholunate ligament is important to maintaining stability whilst loading/weight-bearing and during strong gripping. Injuries to this ligament causes pain, weakness, instability, limited motion and function.
Strain to the ligament can cause widening of the gap between the scaphoid and lunate bones and the scaphoid can flex out of position. Chronic tears left untreated may lead to pain, dysfunction and arthritis.
Treating Scapholunate Injury
For a partial injury, Graham would be treated using a thermoplastic wrist splint and immobilised for 4-6weeks. Graham would be educated on only using his hand for light duties and keeping uninvolved joints moving.
After splint removal, a graded range of motion exercises would be commenced. Specific muscles on the radial side of the wrist are targeted in a proprioceptive strengthening program to help stabilize the scaphoid and support the ligament as it heals. Other softer/smaller splints may be useful when returning to activity/sports.
If your therapist suspects a complete tear, a referral to a surgeon would be arranged.
If you have any questions about a wrist injury, please get in touch today.