Demonstrating palmaris longus, flexor carpi radialis, the interval between the radial artery and the flexor carpi radialis, the incision marked out with the scaphoid waste lying approximately at the level of the wrist crease. Through the subcutaneous tissue to the sheath of the FCR. The FCR tendon is then retracted ulnarly to go through the floor of the sheath of the FCR median nerve. The radial scaphocapotate ligament, sharply incised to develop flaps. Just a little extension of the scapho-trapezial joint. Flaps elevated radial and ulnar, and the volar foot process of the trapezium, which will be removed with a ronger to allow targeting of the screw, so the proximal, excuse me, the distal pole of the scaphoid, and then the overlying volar foot process of the trapezium which can prevent proper targeting. Now with the scaphoid exposed, we can, in the setting of a fracture, insert two F4-5K wires. So through the floor, the radial scaphoid capitate ligament divided, radial ulnar flaps developed, scapho-trapezial joint, radial carpal joint. Two K wires can be inserted to use as joysticks to, for manipulating, for manipulative reduction. And then we can load the cannulated wire.

anatomy

FCR tendon

median nerve

scaphoid

manipulative reduction