The scapholunate ligament has three components — dorsal (strongest), proximal (membranous), and volar. The volar component provides secondary constraint to scapholunate separation and is important in defining the complete SLIL tear versus partial tear patterns. Dynamic instability with both dorsal and volar components torn progresses to DISI deformity (dorsal intercalated segment instability) on radiograph.
| Origin | Volar scaphoid waist |
|---|---|
| Insertion | Volar lunate |
| Actions | Provides the primary constraint against scapholunate dissociation (the volar limb is weaker than the dorsal) |
|---|
Partial SLIL tears (dorsal component intact) maintain radiographic alignment but produce scaphoid shift test pain. Complete SLIL tears (all three components) produce the radiographic triad of scapholunate widening (>3 mm), DISI deformity (lunate dorsiflexion), and scaphoid ring sign on PA wrist X-ray. Reconstruction using the 3-ligament tenodesis or RASL screw addresses complete tears.
Combined dorsal and volar scapholunate ligament rupture producing dynamic instability and DISI deformity managed with ligament reconstruction.
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