Figure 2.

(a) The distal radius is shortened by carving out a piece of bone and replacing it by the scaphoid and lunate. The proximal articular surfaces of the lunate and scaphoid are dechondrified. The triquetrum is released and excised. (b) The scaphoid and lunate are fixated to the dorsal radius using a L-plate 2.4 and locking screws. The ulnar side of the lunate will articulate with the ulnar head as a neo-distal radioulnar joint (DRUJ). (c) Neo-DRUJ showing articulation with the capitate and ulnar bone. Note that the distal pole of the scaphoid (Figure 2b) is excised.