1. Arthroscopically Assisted Ligamentoplasty for Axial and Dorsal Reconstruction of the Scapholunate Ligament 
Vicente Carratalá, M.D., Francisco J. Lucas, M.D., Eduardo Sánchez Alepuz, M.D., Eva Guisasola, M.D., Rafael Calero, M.D. 
Arthroscopy Techniques 
Volume 5, Issue 2, Pages e353-e359 (April 2016)
DOI: /j.eats
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

2. Fig 1
Portals and incisions used in the arthroscopically assisted axial and dorsal scapholunate reconstruction. We use the 3-4 and 6R portal and the MCR (midcarpal radial) and MCU (midcarpal ulnar) portal. Two small incisions are made, the first one at the anatomic snuffbox and the second one, dorsal, just over the lunate.
Arthroscopy Techniques 2016 5, e353-e359DOI: ( /j.eats )
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

3. Fig 2
Arthroscopic visualization through the 3-4 portal; the tip of the C-guide is introduced through the 6R portal (arrow) and placed in the proximal ulnar face of the lunate, in the lunotriquetral joint, and centered on the anteroposterior depth. (L, lunate; R, radius; TFCC, triangular fibrocartilage complex.)
Arthroscopy Techniques 2016 5, e353-e359DOI: ( /j.eats )
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

4. Fig 3
(A) With the wrist in horizontal position, introducing the guide wire through the C-guide. (B) Verifying the correct placement of the guide wire, through the scapholunate joint close to the midpoint or slightly distal until the proximal ulnar corner of the lunate. (C and D) Passing the cannulated drill over the central guide wire. (C) Under fluoroscopic control, we perforate through the SL joint to the farthest corner of the lunate, avoiding piercing the ulnar cortex of the lunate (arrow).
Arthroscopy Techniques 2016 5, e353-e359DOI: ( /j.eats )
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

5. Fig 4
(A) Wrist in horizontal position. Introducing the Graft Anchor (Arthrex) with the tendon graft of double beam through the exterior sheath of the C-guide. (B) Impacting the graft from the ulnar side of the lunate with a hammer. (C) Confirming the position of the anchor by fluoroscopy (arrow). (D) Recovering the free ends of the graft, intra-articularly, from the radial incision to the dorsal and reanchoring it to the dorsal face of the lunate (arrow) using a Micro Corkscrew (Arthrex) anchor.
Arthroscopy Techniques 2016 5, e353-e359DOI: ( /j.eats )
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

6. Fig 5
(A-C) Arthoscopic view from 3-4 portal, confirming the correct passage of the plasty through the scapholunate dorsal face (arrow). A (tendon graft), L (lunate), RS (radial styloid), S (scaphoid), SLL (scapholunate ligament). (D) Through midcarpal arthroscopy (scope at the midcarpal ulnar portal), testing the stability of the scapholunate joint and confirming the correct reduction. C (capitate), L (lunate), S (scaphoid).
Arthroscopy Techniques 2016 5, e353-e359DOI: ( /j.eats )
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

7. Fig 6
The concept of the axial and dorsal reconstruction of the scapholunate ligament, with 2-tailed tendon graft in the axis and the dorsal part of the graft reconstructing the dorsal part of the scapholunate ligament.
Arthroscopy Techniques 2016 5, e353-e359DOI: ( /j.eats )
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions