Anatomic reconstruction of distal radioulnar ligaments. A, Retraction of capsular flap to expose articular surface of distal radioulnar joint and proximal surface of triangular fibrocartilage complex. B, Position of guidewire for creating radial tunnel. C, Location of radial and ulnar tunnels. D, Position of guidewire for creating tunnel through ulnar head and neck (radial tunnel also can be seen). E, Deep exposure and location of bone tunnels for tendon graft. F, Tendon graft passed through bone tunnels and volar capsule of distal radioulnar joint. G, Completed passage of tendon graft. (A, C, E-G, redrawn from and B and D from Adams BD, Berger RA: An anatomic reconstruction of the distal radioulnar ligaments for posttraumatic distal radioulnar joint instability, J Hand Surg 27A:243, 2002.) SEE TECHNIQUE 69.30.