J Wrist Surg 2013; 02(02): 136-140
DOI: 10.1055/s-0033-1341960
Special Focus: The Schapholunate Ligament Complex
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Scapholunate Instability: Proprioception and Neuromuscular Control

Guillem Salva-Coll
1   Department of Hand and Microsurgery, Son Llàtzer Hospital, Ibacma Institute, Palma de Mallorca, Spain
Marc Garcia-Elias
2   Institut Kaplan, Barcelona, Spain
3   Department of Anatomy, University of Barcelona, Barcelona, Spain
Elisabet Hagert
4   Karolinska Institutet, Stockholm, Sweden
5   Department of Clinical Science and Education, Hand and Foot Surgery Center, Stockholm, Sweden
› Author Affiliations
Further Information

Publication History

Publication Date:
21 May 2013 (online)


From a kinetic point of view, the wrist is considered stable when it is capable of resisting load without suffering injury. Several prerequisites are necessary for the wrist to be kinetically stable: bone morphology, normal articulating surfaces, ligaments, the sensorimotor system, the muscles crossing the wrist, and all nerves connecting to ligaments and muscles. Failure of any one of these factors may result in carpal instability. The terms “scapholunate (SL) dissociation” and “SL instability” refer to one of the most frequent types of wrist instability, resulting from rupture or attenuation of the SL supporting ligaments. From a radiologic point of view, SL instability may be dynamic or static. Unlike static instabilities, which tend to be painful and dysfunctional, a good proportion of dynamic SL instabilities remain asymptomatic and stable for prolonged periods of time. Such a lack of symptoms suggests that a ligament rupture, in itself, is not enough for a joint to become unstable. Certainly, the process of achieving stability is multifactorial and involves normal joint surfaces, ligaments, muscles, and a complex network of neural connections linking all these elements. In this article, we will review the neuromuscular stabilization of the SL joint and the proprioceptive mechanisms that contribute to the dynamic carpal stabilization.


The work was performed in the laboratory of biomechanics in the Department of Anatomy, University of Barcelona, Barcelona, Spain and Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.

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