Central or dorsal wrist pain
Pain is often felt near the back-centre of the wrist.
Central wrist ligament · Carpal instability
Scapholunate Ligament Injury Symptoms & Treatment
Persistent pain in the centre or back of the wrist after a fall can reflect injury to the ligament joining the scaphoid and lunate. Early assessment matters because an unstable tear can alter carpal alignment and may lead to progressive arthritis.
Central wrist painPain after a fallClicking or clunkingWeak grip
Patient guideSymptoms → Diagnosis → Treatment → Recovery
Specialist hand & wrist assessment
What is injured?
The ligament connecting the scaphoid and lunate bones in the centre of the wrist.
Typical clue
Pain or clicking after a fall, especially with pushing, gripping or wrist extension.
How diagnosed?
Examination plus carefully positioned X-rays, with MRI or arthroscopy when useful.
Why timing matters
Acute repair is usually more straightforward than reconstruction of a chronic unstable wrist.
Understanding the condition
What is a scapholunate ligament injury?
The scapholunate ligament is a key stabiliser between two bones in the proximal carpal row. A complete tear can allow the scaphoid and lunate to move abnormally apart.
Injuries range from a mild sprain to a complete unstable rupture. Symptoms and standard X-rays may initially look modest, so persistent pain after a fall deserves review.
Clear diagnosis before treatmentSimilar symptoms can arise from the neck, elbow, wrist, tendons or joints. The examination is designed to locate the true source.
What patients may notice
Symptoms worth checking early.
Symptoms vary with the injured wrist structure and how long function has been affected. Persistent pain, clicking, stiffness, weakness or instability deserves specialist assessment.
Pain with pushing up
Chair push-ups, press-ups or loaded wrist extension may hurt.
Clicking or clunking
The wrist may feel as though it shifts under load.
Weak grip
Grip and lifting can feel painful or unreliable.
Swelling after a fall
Acute injury can cause local swelling and tenderness.
Persistent “sprain” symptoms
Pain that does not settle as expected can signal a deeper ligament injury.
Why it happens
How the scapholunate ligament is injured
A useful consultation connects pain location, stability, imaging and function to the exact wrist structure—not just the label.
Fall on an outstretched hand
A high-force fall can tear the ligament.
Sports or impact injury
Gymnastics, contact sport and high-load extension can injure the carpus.
Associated fracture or dislocation
The ligament may be damaged within a more complex wrist injury.
Chronic attenuation
Less commonly, inflammatory or degenerative change can weaken carpal ligaments.
Focused diagnosis
Find the structure, the stability and the severity.
Assessment focuses on whether the ligament is merely painful or mechanically unstable, and whether the carpal bones have already changed alignment.
Bring to your appointmentPrevious X-rays, MRI scans, reports, braces and information about work, sport or activities that trigger symptoms.
Mechanism and examination
Pain location, loading symptoms and instability tests are recorded.
Standard and stress X-rays
Comparative or clenched-fist views may reveal widening or abnormal angles.
MRI or CT
Advanced imaging may define ligament and cartilage injury in selected cases.
Diagnostic arthroscopy
Arthroscopy remains the most direct way to grade some ligament injuries.
Treatment choices
Start with the option that fits the diagnosis.
Surgery is not automatic. Treatment is matched to pain, stability, cartilage condition, imaging and the patient’s goals.
Non-surgical care
Reduce irritation, protect function and review progress.
- ImmobilisationSelected partial or stable injuries may be protected in a cast or splint.
- Activity modificationAvoid loaded extension, heavy gripping and impact while symptoms settle.
- Hand therapyMotion and strength are restored without provoking instability.
- Pain controlAppropriate medication or selected injection may help symptoms but does not reconnect a complete unstable tear.
- SurveillanceRepeat examination or imaging may be required if symptoms persist.
Surgical pathway
Re-establish carpal alignment before instability becomes fixed.
- Acute ligament repairA repairable recent tear may be reattached and temporarily stabilised.
- Arthroscopic treatmentSelected partial injuries may be assessed or treated arthroscopically.
- Ligament reconstructionChronic instability may require tendon graft or another reconstructive technique.
- Salvage for established arthritisWhen cartilage damage is advanced, procedures focus on pain relief and useful function.
Surgery when appropriate
Scapholunate ligament repair or reconstruction
Surgery may be recommended for a complete unstable injury, particularly when diagnosed early, or for chronic symptoms with demonstrable instability. The exact method depends on tissue quality, reducibility and cartilage condition.
- Confirm the degree and age of instability
- Assess cartilage and associated ligament damage
- Repair or reconstruct the scapholunate ligament
- Temporarily stabilise the carpal bones when required
- Protect the reconstruction and begin staged rehabilitation
Realistic expectationsEven with treatment, some stiffness and reduced grip can remain. The goals are pain reduction, useful stability and prevention or delay of progressive collapse.
Specialist pathwayDiagnosis → Procedure → Therapy → Recovery
Recovery pathway
Healing is staged—not rushed.
Timelines are guides only. The diagnosis, procedure, stability, cartilage condition, job and associated injuries all influence recovery.
First weeks
The wrist is immobilised and finger motion is maintained.
6–12 weeks
Pins or casts may be removed according to the reconstruction; therapy begins gradually.
3–6 months
Strength and functional loading progress in stages.
Longer term
Recovery after reconstruction can continue for many months and return to heavy sport is individual.
4.96/555 verified reviewsWhy consult Dr Arshad
A clear diagnosis. Practical options. A plan built around you.
Dr Shoaib Arshad is a fellowship-trained consultant orthopaedic hand and wrist surgeon with UK specialist training and more than 17 years in orthopaedic surgery.
Focused hand, wrist and upper-limb assessmentNon-surgical and surgical treatment pathwaysPrivate consultations at The Highfield Hospital, Rochdale, for patients across Greater Manchester and the North West
Meet Dr Arshad ↗Questions patients ask
Scapholunate Ligament Injury FAQs.
General information only. Your diagnosis and treatment plan should be based on an individual medical assessment.
Is a scapholunate tear just a wrist sprain?+
It is a ligament injury, but complete tears can create carpal instability and deserve more specific assessment than a simple mild sprain.
Can X-rays be normal?+
Yes. Early or partial injuries may not show on routine views. Stress X-rays, MRI or arthroscopy may be needed.
Does the ligament heal on its own?+
A complete unstable tear generally does not restore normal anatomy without treatment. Partial stable injuries may settle with protection.
What happens if it is untreated?+
Persistent instability can change wrist mechanics and may lead to scapholunate advanced collapse arthritis over time.
Where does Dr Arshad see patients?+
Dr Arshad sees private patients at The Highfield Hospital, Manchester Road, Rochdale OL11 4LZ — within easy reach of Manchester, Oldham, Bury, Bolton and the wider North West. You can book online through Circle Health Group, call +44 7443 213645, or send an enquiry and the team will help.
Medical referencesPatient information sources used for this guide
The Highfield Hospital · Rochdale, Greater Manchester
Ready for a clear wrist assessment?
Request a specialist consultation and bring any previous X-rays, MRI scans, reports, braces or treatment information.