The dorsal intercarpal ligament is then prepared for reinsertion. After a chronic lesion, it is found to be retracted lying more distal to its anatomical position over the lunate and the dorsal groove of the scaphoid, and usually adherent to the carpus [16]. It can be dissected off using the scalpel, taking care not to section it (Fig. 3). The scaphoid groove and the dorsal horn of the lunate are freshened using a rasper (Fig. 4). The dorsal intercarpal ligament can now be transferred to the dorsal scapholunate interval. If the capsule is retracted and the DICL cannot be properly mobilized, it can be detached from the rest of the capsule by an incision parallel to the initial one (Fig. 5), along its distal border. Once it is at the scapholunate interval, it is secured by two anchors, sometimes three or four, taking care to maintain transverse tension on the fibres of the DICL to maintain reduction and keep the scapholunate junction closed (Fig. 6).

The transverse capsular incisions are left open so as not to limit postoperative wrist flexion. Once the tendons are repositioned, the retinaculum is repaired by two x stitches with braided absorbable 2/0 suture. The K-wire is cut but kept long enough so that EPL does not pass over it and rupture. The skin is sutured using simple stitches of nonabsorbable 4/0 monofilament over a drain. If the patient is compliant, a simple enforced removable splint is placed, facilitating dressings and allowing forearm swelling and remission. Fingers are allowed mobilization in space with no grip or loading to avoid any distraction at the scapholunate interval.