Once the K-wires are placed, the threaded APL tendon is put under tension and incorporated into the capsular closure by figure of eight sutures, doubly sutured to the cut edges of the capsule. The free end of the anchoring tendon slip is tucked inside the capsule with the anchovy.
The position of fixation should take into account the danger of compressing the immediately adjacent carpal tunnel. If the patient has a mild carpal tunnel preoperatively, this will be released prophylactically during this procedure.
Expert consultant: Dr. Thomas Shepler, The Manus Center, Vienna, VA
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