Scapholunate ligament reconstruction
What is scapholunate ligament reconstruction?
The scapholunate ligament joins two small bones in the wrist together – the scaphoid (near the base of your thumb) and lunate (near the middle of your wrist). It’s the most commonly injured ligament in the wrist – often from a fall onto an outstretched hand. Injuring the scapholunate ligament can cause the scaphoid and lunate bones to partially or completely separate.
At Aspire Orthopaedics, Dr Jonathon de Hoog provides reconstructive surgery for torn scapholunate ligaments. With a special interest in hand and wrist surgery, he proudly brings leading surgical care to Townsville, Pimlico, and Mt Isa.
How does scapholunate ligament reconstruction help?
In a healthy wrist joint, the scapholunate ligament stabilises the wrist and holds the scaphoid and lunate bones close together. If the ligament is damaged, these bones are destabilised. They can move disjointedly, causing pain and eventually leading to arthritis.
The goal of scapholunate ligament reconstruction is to secure the scaphoid and lunate bones back together by replacing the severed tendon. When the bones work together again, most patients find that pain is relieved and the joint is much more stable.
Is scapholunate ligament reconstruction right for me?
Scapholunate reconstruction is usually reserved for fully severed tendons. The ends of a severed tendon usually don’t reattach on their own and surgery could help restore stability to your wrist. If the tendon is damaged without being fully torn, a repair procedure might be a better fit.
Dr Jonathan de Hoog will always ask you about your lifestyle needs and expected outcomes before your surgery. If scapholunate ligament reconstruction isn’t the best approach for you, he can recommend an alternative treatment.
What happens in a scapholunate ligament reconstruction surgery?
Scapholunate reconstruction can take place under a local or general anaesthetic. After reviewing any x-rays and scans, Dr Jonathan de Hoog makes an incision in the back of your wrist to expose the scaphoid and lunate bones. He then places K-wires in them: these are stiff, straight pins with sharp ends which hold the bones in place during surgery and healing.
Small holes are then drilled in the scaphoid and lunate bones and connected to form a tunnel. The doctor passes a tendon graft or synthetic material through the hole and secures it in place. He checks your wrist’s range of motion and the bones’ alignment using a fluoroscopy before he closes the incision with stitches, applies a dressing, and fits a cast.
Getting ready for surgery
- Arrange a support person – you will need someone to drive you home and stay with you afterwards.
- See your GP – you may need to cease smoking and taking some medications or make lifestyle changes before surgery.
- Prepare your wrist – Dr de Hoog may recommend exercises to strengthen your wrist’s muscles for improved recovery.
- Follow any other instructions – you may be given individualised advice for preparation.
- Your arm will be in a cast for 6-8 weeks
- You may have K-pins (wires) poking out of your skin – these will be removed along with the cast.
- You will start strength training therapy once the cast comes off – Dr de Hoog will provide specific exercises.
- Your wrist stability will continue improving over 6-12 months.
- You can drive again when you are off pain medication and can comfortably grip the steering wheel.
Contact Aspire Orthopaedics
At Aspire Orthopaedics, Dr Jonathon de Hoog manages orthopaedic conditions from locations across Townsville, Pimlico and Mt. Isa.