Thread: Scaphoid Lunate ligament damage: Anybody done this?

Fucked up my wrist playing hockey.

Diagnosed as a partial ligament tear. Waiting for my MRI.

Anybody have any experience with this type of injury?

Nothing helpful, but I wanted to thank you for posting. I googled your injury just out of curiosity, and some research prompted me to read the thread about scaphoid fractures and finally make an appt to get my self-diagnosed "sprained" wrist looked at. Maybe it's nothing, but this might save me some agony, so appreciate the timely post. Best of luck with the recovery.

My on advice: see a certified hand surgeon. For the best recommendation, call some certified hand therapists (enter a zipcode here http://www.htcc.org/locate/index.cfm). They tend to know who the good and bad surgeons are cuz they have to clean up the mess.

Sorry to hear about your injury, Clownshoe. The wrist is made up of seven major bones lying in two rows, and the scapholunate (SL) ligament is a major ligament that holds the "scaphoid" bone and the "lunate" bone together in the first row. Its importance is that, as you can imagine, the movement of seven bones at once during normal wrist use is incredibly complex, and the ligaments help ensure appropriate orientation/motion. If the SL ligament is completely torn, the dissociation between the scaphoid and lunate can lead to long term problems, specifically arthritis (wear and tear of the cartilage). A frequent clinical presentation is someone showing up with wrist arthritis and, when asked if there was a prior injury, remembering that he/she "sprained" his/her wrist a decade or more ago.

Agreed with above post. Once you have the MRI results go see a certified hand surgeon.

Best of luck...

Thanks for the kind words guys! I'm luck to live in Whistler, where the doctors see lots of sports injuries, so I received a good diagnosis in my initial visit to the ER.

Compared to some other injuries I read about on here, I feel like this is a pretty minor injury. I can still ski and with my cast on I can ride my bike on pavement, so it could be worse.

I'm definately concerned about the long term problems associated with a poor recovery from this type of injury, so I'm anxious to get the results of my MRI to see if I need surgery.

The ER doc indicated that in a full ligament rupture, the scaphoid tilts in one way and the lunate tilts the other way, making for an "easy" diagnosis. That's not the case on my xray. However, the gap between the schaphoid and lunate is twice as big on my injured hand, compared to the uninjured one, so I've definately done something to it.

A gap on xray is indeed suggestive of a tear - often that's not seen unless someone is making a fist (i.e., a regular xray can look normal). The tilt component is on a lateral (sideways) view of the wrist. The key point is that if it is a tear, repairing it immediately after the injury is much better than waiting, in which case a reconstruction would be necessary. Therefore, regardless of the MRI read (partial vs. complete), I would see a hand surgeon within the next week and discuss your options. Again, best of luck.

So...apparently I didn't break my scaphoid. Hand surgeon is thinking partial tear of the ... you guessed it - scaphoid-lunate ligament! (or maybe some palmar ligament which apparently doesn't even show up on an MRI...?) Have instability in the wrist so it's not just "sprained," despite my hopes and dreams.

Clownshoes - how did it turn out for you? Did you cast it or what? I had no bruising and minimal swelling, but it's 7 weeks and is still pretty painful at times, though the worst pain was following climbing at week 3 and cycling at week 5 (minimal pain during, but pretty intense for a few days starting the next day).

I don't think I can handle another surgery.

I'm about 5 weeks since the injury. It doesn't hurt hardly at all anymore, but if someone gives me a good firm handshake without my splint on, I can still feel it. I'm wearing a removable splint if I'm going out of the house or if I'm going to have a couple beers.

I had it in a hard cast for 2 weeks, then more consults with the doc and surgeon, then 3 more weeks in a removable hard splint. One more week in this splint, then back to the doc/surgeon for a followup.

Still waiting on an MRI. I guess that's the mixed blessing of Canada's health care system. It hasn't cost me anything to get x rays and casts and surgeon consults, but it could be months before I get an MRI. I might break down and pay for it if I get a bad result when I go back to the surgeon.

I've been very careful not to stress it to much, as I'm hoping to be back on the DH bike as soon as the 6 weeks is out, but I'm skeptical that I'll get the green light.

Like you, I've had minimal swelling, including when I hurt it initially. Definitely could tell I'd fucked something up though. Even the next day when I finally went to the clinic, there was no swelling at all.

Strangely, its my forearm that hurts now. I think its from the pressure that the splint puts on my arm when I'm wearing it and trying to carry something

P.S. One of our mottos on the ski/bike patrol is "There's no such thing as a sprained wrist"

Very cool. Sounds like mine may have actually been a little worse than yours, despite my desperately thinking I didn't fuck it up for real.

Nobody's given me a brace to wear, so I've just been doing my thing. Feels pretty good alot of the time (minus the times I went climbing and cycling). I was wearing an over the counter brace to sleep, but now I pretty much just use it for playing soccer. Scary thing it is sometimes hurts randomly. I fucking hate that shit. It makes me feel like it might not heal without some sort of surgery.

I'd be careful about biking. Even getting on the road bike around week 5 was quite painful. The worst part was it didn't hurt too badly while riding or even the day after, but started hurting two days afterwards and continued for a week. I definitely wouldn't want to ride DH bike at the moment, but I hope yours is coming along better than mine.

I'm gonna lay off it for another month and see what happens.

ETA: Where is the main source of your pain? For me, it seems to be right on the center of the back of my hand at the wrist joint: ie, right between my anatomical snuffbox and TFCC. Just curious if yours hurts in the same spot.

Ya, don't sleep on this injury. As others have mentioned here, this can lead to life long problems if you don't get it sorted properly.

Good luck! Keep me posted fellow pseudo cripple!

Nah, for sure. Got an MRI and see the surgeon again in a week. He thinks a shot of cortizone might do the trick, pending the MRI results.

Where's your pain? (See the edit to my last post for where mine hurts). Curious if it's the same place.

Yes, my pain ws in the exact same spot as you describe for the initial injury. Just beside the snuffbox, one bone over towards the middle of the back of my hand. Very localized pain, so localized that I had trouble finding it until I pressed on the exact spot where that ligament is (I've become an expert on the ligaments and bones in there the past month). Pain there is pretty much gone now, but I'm too scared to test it out too much for another week or two.

Now the strange pain for me is halfway to my elbow in the muscle that runs between my radius and ulna, just below where the splint finishes.

Interesting. I have never been able to actually locate that ligament, despite being well-versed in the anatomy. Even my hand therapist couldn't find a localized source of the pain through manipulation. Makes me curious...

Sounds like the split is causing some muscle soreness in your extensor tendons. Pretty sure that's not uncommon. I'd wait until you're ready to ditch the splint and then see if the doc won't let you see a CHT for a good massage to work the muscles loose.

Thanks for the quick responses.

Update: Got the green light to get back on the DH bike yesterday.

Went for two pain free laps in the Whistler Park. Stoked.

Initial guess was 6 weeks. I waited 7 just to be sure.

Also, damn socialized medicine! STILL no MRI appointment in sight.