Wrist Instability (Lunotriquetral Ligament Injuries): Overview

Wrist Instability (Lunotriquetral Ligament Injuries): Overview

This video will provide an overview of lunotriquetral, or L T, joint injuries. The wrist has many important bones, joints, and ligaments that maintain its stability. The lunotriquetral, or LT, joint is one of these important areas. It lies between the lunate and triquetrum, 2 of the wrist bones.

Injury to this joint often involves the primary ligament that connects these bones, the LT ligament. This ligament is a C-shaped ligament that connects the lunate and triquetrum. An injury to the LT ligament can go undiagnosed given its rarity in isolation. Often, injury to this ligament occurs alongside injury to other nearby ligaments in the wrist.

Injuries to this joint are classified by the severity of the LT ligament tear. A grade 1 injury is a partial tear of the ligament. A grade 2 injury is a complete tear of the ligament at the base of the wrist. There will also be instability of the joint with movement. A grade 3 injury is a complete tear of the ligament at the base and top of the wrist. Here, there is instability of the joint without movement. The severity of the tear is important when deciding how to treat the injury.

Injuries to this joint are uncommon. However, they remain the second most common ligament injury in the wrist that leads to instability. These injuries, if unrecognized, can lead to impairment in daily activities and the development of arthritis.

LT joint injuries are most often the result of a high-impact fall on an outstretched hand with the wrist extended. Younger athletic populations are most associated with this condition. LT tears can also be the result of chronic causes, such as prior wrist injuries or anatomic variants that make one susceptible to this over time.

Patients may report pain that is localized to the outer side of the wrist. Decreased motion, strength, instability, and painful clicking have also been reported. A health care provider will perform a detailed examination of the wrist to help make the diagnosis. Given this can be difficult to diagnose, there are specific examination methods that can be helpful for the health care provider.

X-rays are often taken initially to help diagnose wrist pain. They are often normal in this injury. Thus, more advanced imaging may be required. A procedure called a diagnostic arthroscopy, in which a surgeon uses a small camera to directly evaluate the ligaments in the joint, is the preferred diagnostic method.

After a health care provider has reviewed the patient's history, examination, imaging, and possibly an arthroscopic evaluation, a treatment plan will be discussed.