The Orthobullets Podcast Hand | Lunotriquetral Ligament Injury & VISI
Aug 27, 2025
Dive into the intricate world of lunotriquetral ligament injuries, where anatomy meets action! Discover how a long ulna influences triquetral ligament tears and leads to wrist instability. Learn about the critical diagnostic techniques that differentiate these injuries from others. The podcast also highlights various treatment strategies, from non-operative to surgical options, emphasizing the anatomy and biomechanics involved. Get insights that could be a game-changer for those dealing with wrist conditions!
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VISI From LT Injury Is Radiographically Distinct
- Lunotriquetral (LT) injuries are rare but can produce volar intercalated segment instability (VISI) when combined with dorsal radiocarpal ligament injury.
- Diagnosis rests on lateral radiographs showing lunate volar flexion and SL angle <30°.
LT Ligament Has Unequal Regional Strength
- The LT ligament has dorsal, proximal (membranous), and volar components with the volar portion strongest.
- The dorsal LT fibers mainly control rotation while volar fibers transmit triquetrum extension moments.
Use Specific Provocative Tests For LT Tears
- Perform targeted physical tests: LT shock (Belotman), Kleinman's shear, and LT compression when ulnar-sided pain is present.
- A positive test shows pain, crepitus, clunk, or increased laxity suggesting LT interosseous injury.