The lunotriquetral ligament connects the lunate and triquetrum to coordinate their movement as the medial carpal unit. Its tear produces a VISI (volar intercalated segment instability) pattern where both bones flex together, less commonly than the DISI of scapholunate injury. Lunotriquetral ligament tears present with ulnar-sided wrist pain at the LT joint and a positive Reagan ballottement test.
| Origin | Lunate medial surface |
|---|---|
| Insertion | Triquetrum lateral surface |
| Actions | Maintains lunate-triquetrum alignment during wrist motion |
|---|
LT ligament tears are often partial and can occur in isolation or as part of perilunate instability. The Reagan ballottement test (shucking the lunate against the triquetrum) reproduces the pain and may elicit a clunk in complete tears. Isolated partial LT tears are managed with immobilisation and platelet-rich plasma or corticosteroid injection, while complete tears with VISI deformity require arthroscopic or open ligament repair.
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.
