With the wires reducing the scaphoid and lunate, the articularcartilage is carefully removed from the opposing scaphoid and lunate surfaces with amechanical burr until punctuate subchondralbleeding is observed(Fig. 5).This facilitates ingrowth of fibrous connective tissue. If aremnant of the SL ligament is present, it is not debrided but left to add to the fibrous connective tissue at the interface. AKocher clamp is placed across the joystick K-wires after reduction is confirmed (Fig. 6). Aguide wire for the cannulated, Standard HeadlessBoneScrew (HandInnovations, Miami, Florida, U.S.A.) is placed into the radial midwaist of the scaphoid exiting the scaphoid at the mid-point of its articular surface opposite the lunate, across the joint, and then into the center of thelunatepointingtowardsthe medial vertex on the coronal image and the middle of the lunate on the lateral image (Figs. 7and 8). The cannulated drill is placed over the guide wire and the hole is drilled. Then, the screw length is measured with acannulated guide and the screw is advanced over the guide wire. The length should be slightly less than the length measured from the guide wire to allow counter­sinking of the screw beneath the scaphoid surface. All K-wires are removed.