Lunotriquetral Ligament

Lunotriquetral ligament injuries are a relatively common cause of wrist pain on the ulnar side. Injuries range from partially stable ligament ruptures to widespread lunar instability.

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Clinically Relevant Anatomy

• The lunotriquetral ligament unites the lunate and triquetrum of the carpals.
• It originates from the volar side of the distal lunate and triangular fibrocartilage and attaches itself distally to the medial end of the hammate.
• Similar to the scapholunate ligament, there are three sections: the volar ligament, the proximal ligament, and the dorsal ligament.

Dorsal component

• It is less flexible than the scapholunate ligament.
• It limits the amount of dorsiflexion between the lunate and triquetrum.

Volar component

• The ligament is important component contributing to carpal stability.
• It limits triquetral extension and is linear in shape.
• It runs parallel to the space between the lunate and triquetrum.
• Some fibres are joined by the volar ulnolunate ligament

Proximal component

• It is triangular in shape with the apex directed distally
• Some fibres are joined by the superficial fibres of the volar radiolunate ligament

Mechanism of Injury / Pathological Process

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Clinical Presentation

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Diagnostic Procedures

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Outcome Measures

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Management / Interventions

Conservative treatments are generally considered to be the first-line treatment for mild lunotriquetrical instability.

Temporary arthroscopic pinning and / or wound resection is recommended as minimally invasive surgery.

Surgical interventions can be performed for more dissociative injuries.

The literature suggests that soft tissue reconstruction is an effective procedure for this group.

Arthrodesis of lunotriquetral joints is associated with a high nonunion rate (up to 57%), so the indications for surgery need to be very clear.

Differential Diagnosis

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Key Evidence

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Resources

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