The skin incision is made proximally between the extensor carpi radialis- and common digital extensor muscles and tendons progressing distally over the common digital extensor tendon.
2. Deep incision
The deep incision separates the extensor carpi radialis and common digital extensor muscles and tendons proximally. At the level of the carpus the annular ligament of the carpus is incised exposing the joint capsule. Distally the common digital extensor tendon is split longitudinally progressing distally on the dorsolateral metacarpus.
3. Joint reflection
For a pan-carpal arthrodesis the joint capsule from all three joints is reflected.