Table 3.

Treatment algorithm for lunotriquetral ligament injury

Lunotriquetral interosseous ligament injury
Injury pattern	Treatment strategy
Predynamic or occult instability (partial LTIL injury)	Immobilization Arthroscopic debridement ± pinning
Acute complete injury with reparable LTIL	Primary soft tissue repair with or without capsulodesis
Complete injury with irreparable ligament or VISI	Capsulodesis Reconstruction with tenodesis Lunotriquetral arthrodesis Ulnar shortening osteotomy
Ulnocarpal impaction syndrome	Ulnar shortening osteotomy

The severity and injury type in the left column is shown with increasing severity from top to bottom. A proposed treatment for the injury diagnosed is listed in the column to the right. Adapted with permission from Paci GM, Yao J. Surgical techniques for the treatment of carpal ligament injury in the athlete. Clin Sports Med. 2015;34(1):11-35. doi:10.1016/j.csm.2014.09.010