[Carpal instability. General therapeutic principles]

Ligamentous injuries must be looked for and repaired on an emergency basis. Correct alignment may be achieved by pinning through a posterior approach. Secondary repair is hazardous. When dealing with compensatory carpal malalignments, intracarpal surgery should strive not only to correct the one bone involved but the entire carpal complex and, in particular, to correct the horizontally tilted scaphoid which may otherwise lead to arthrosis.