The lunotriquetral joint is the articulation between the medial surface of the lunate and the lateral surface of the triquetrum in the proximal carpal row. It is stabilised by the lunotriquetral interosseous ligament and the extrinsic ulnotriquetral ligament. Normal lunotriquetral motion is coupled with the scapholunate joint, maintaining the proximal carpal row as a single intercalated segment.
Lunotriquetral dissociation from ligament disruption produces volar intercalated segment instability (VISI), the less common carpal instability pattern, where the lunate tilts into palmar flexion. The Reagan (lunotriquetral shear) test reproduces pain by loading the joint. Ulnar-sided wrist pain from LT ligament injury is often confused with TFCC pathology. MRI arthrography has limited sensitivity for LT ligament tears compared to arthroscopy. Management ranges from immobilisation and corticosteroid injection for partial tears to arthroscopic repair or lunotriquetral arthrodesis for complete tears.
Disruption of the lunotriquetral interosseous ligament produces ulnar-sided wrist pain, a positive lunotriquetral shear test, and VISI deformity on lateral radiograph; managed with immobilisation for partial tears or arthroscopic repair and temporary K-wire fixation for complete tears.
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