The radioscapholunate ligament (ligament of Testut-Kuentz) is an intrasynovial neurovascular structure passing from the anterior radius to the scapholunate junction, often described as a ligament but primarily functioning as a conduit for the vascular supply to the proximal scaphoid and lunate.
Transmits blood supply to the proximal scaphoid and lunate from the radial artery, provides a minor constraint at the RSL junction, and is preserved in dorsal wrist approaches to maintain scaphoid vascularity.
The RSL ligament is identified during wrist arthroscopy as a soft tissue fold on the radial floor — its division in radiocarpal surgery may devascularise the proximal scaphoid. In Preiser disease (idiopathic proximal scaphoid AVN), RSL ligament vascular disruption has been proposed as a contributing mechanism.
The RSL ligament transmitting radial artery branches to the proximal scaphoid — its preservation in radiocarpal surgery is essential to avoid iatrogenic proximal scaphoid avascular necrosis.
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