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It has become clear that the stability of the scapholunate joint is not dependent wholly upon the scapholunate interosseous ligament but rather upon both primary and secondary stabilizers, which form a scapholunate ligament complex. Each case of scapholunate instability is unique and therefore should be treated with tissue-specific repairs, which may partly explain why a single procedure cannot successfully restore joint stability in every case. Not all lunotriquetral ligament tears are traumatic. The optimal treatment of symptomatic tears is still uncertain. Wrist arthroscopy has a pivotal role in both the assessment and treatment of these derangements.