Use a curved elevator for joint surface reduction and the opposing articular surface(s) as a template.
It may be helpful to have a variety of elevators available to aid reduction.
Osteochondral fragments should be salvaged and secured with small lag screws if possible. Before screw fixation, a bone graft can be used to backfill any defect. If screw fixation is not possible, pins or K-wires can be used. K-wires can be cut and left in situ.
Ideally, joint reconstruction should be performed by inserting hardware only into the navicular.
While hardware may be inserted into the cuboid or cuneiforms for added support, mobility of the talonavicular joint should be maintained.
When adjacent joint surfaces are used as a template, verification of the reduction can become problematic if the fragments are fixed with a trans articular K-wire.
While reconstructing the joint surface, frequently check visually and radiographically to ensure no malreduction.