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6Additional fixation

Additional palmar ligamentous avulsion reattachment

Dorsal carpal subluxation may be associated with avulsion of the palmar wrist capsule from the distal radius.

After dorsal fixation, check the carpal position and stability under image intensification. If there is carpal ulnar and/or palmar translation, consider an additional palmar approach to repair soft tissues.  The capsule can be reattached using multiple suture anchors or transosseous sutures.