Wrist fusion with bone grafting and plate fixation. A, Rigid fusion column through carpus to metacarpal must coincide with plate placement. All joints spanned directly by plate should be fused; adjacent joints can be fused if desired. B and C, Placement of 3.5-mm dynamic compression plate; note local distal radial bone graft portal (arrow) and thickness of plate distally. D, Dorsal cartilage is denuded, and plate is applied from distal to proximal, spanning local radial bone graft augmentation. (From Weiss APC, Hastings H II: Wrist arthrodesis for traumatic conditions: a study of plate and local bone graft application, J Hand Surg 20A:50, 1995.) SEE TECHNIQUE 69.43.