Scapholunate (s-l) instability is the most common form of carpal instability. The treatment of this disorder is challenging and varying treatment options have been described, including intercarpal arthrodesis and dorsal capsulodesis. However, treatment of chronic scapholunate dissociation remains unsatisfactory. We wished to examine the long-term results of ligamentous repair and capsulodesis alone for cases of chronic scapholunate dissociation. A retrospective analysis was preformed on 398 wrist procedures preformed between January 1990 and February of 2000. 31 patients were identified with isolated chronic s-l dissociation, being defined as wrist pain present for greater than 3 months. All patients underwent direct scapho-lunate repair in conjunction with a dorsal capsulodesis procedure. Dorsal capsulodesis was preformed with either a modified Blatt technique or with a Mayo method of using a portion of the dorsal intercarpal ligament attached to the lunate. Results were reviewed clinically and radiologically. Static and dynamic instability was defined by radiological and established arthroscopic criteria. Patients had to have a minimum follow up of two years for inclusion in the study. Of the 31 patients, 18 had dynamic lesions and 13 had static lesions. 20 were men and 11 were women. Average age at the time of surgery was 38 years, range (17-76). The average time from injury to surgery was 20 months. 29 patients had a definite history of an acute injury, while 2 had a history of pain following repetitive use at work or sports. Average length of follow up was 54 months (4.5 years). Overall decreased in total wrist motion was 30% following capsulodesis. Average grip strength was 83% of pre-operative levels. All patients had improvement in pain, but only two patients were pain free. Average Mayo wrist score was 73. There was no statistical difference in overall wrist motion, grip strength or wrist score between the dynamic and static group. Of the 31 patients only nine had either good or excellent results. Time to surgery and age had no significant effect on overall outcome. Patients who underwent a capsulodesis that did not cross the radiocarpal joint tended to have higher Mayo wrist scores than patients who underwent a Blatt type capsulodesis. In conclusion repair of the scapholunate ligament with dorsal capsulodesis alone failed to provide consistent pain relief in the majority of patients. In addition only 35% of patients obtained a good or excellent functional improvement.