The lunotriquetral ligament connects the lunate and triquetrum to coordinate their movement within the proximal carpal row. Like the scapholunate ligament it has dorsal, proximal (membranous) and palmar parts, but here the palmar part is the strongest. Its tear, especially with injury to the dorsal extrinsic ligaments, produces a VISI (volar intercalated segment instability) pattern in which the lunate flexes with the scaphoid, the ulnar-side counterpart of the DISI seen in scapholunate injury.
| Origin | Lunate medial surface |
|---|---|
| Insertion | Triquetrum lateral surface |
| Actions |
|
|---|
Binds the lunate to the triquetrum so they move as a unit, preventing lunotriquetral dissociation and VISI collapse.
LT ligament tears are often partial and can occur in isolation or as part of perilunate instability. They produce ulnar-sided wrist pain at the LT joint, and the Reagan ballottement test or Kleinman shear test (shucking the lunate against the triquetrum) reproduces the pain and may elicit a clunk in complete tears. Partial tears are managed with immobilisation, injection or arthroscopic debridement. Complete tears with VISI deformity may require ligament repair or reconstruction, or LT fusion, which reliably relieves pain at the cost of some wrist motion.
LT ligament disruption producing ulnar wrist pain with a positive Reagan ballottement test, managed with immobilisation for partial tears and surgical repair for complete instability.
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