Lunotriquetral ligament instability

Background

• Ulnar equivalent of the scapholunate ligament injury
• May be confused w/ other causes of ulnar-sided wrist pain
• Results from FOOSH with impact on hypothenar eminence

Clinical Features

• Localized tenderness on ulnar aspect of wrist just distal to ulna

Diagnosis

• Note: subtle injuries may have normal radiographic appearance
• Imaging
  • Lateral
    • Volar intercalated segment instability is seen
      • Lunate tilts palmar producing zigzag pattern opposite of scapholunate injury
  • PA
    • Widening of the triquetrolunate joint space

Management

• Ulnar gutter splint or short arm posterior mold; referral to orthopedist