Most surgical techniques involve the insertion of headless screws K wires. Open techniques Nonunions and fractures with unacceptable and irreducible displacement. Percutaneous techniques Acute fractures with no minimal displacement. Approach Volar and dorsal. Depends upon fracture location. Proximal pole Dorsal Antegrade Distal pole Volar. Retrograde . Waist fracture Either approach. Associated injuries Associated instability Dorsal intercalated segment instability secondary osteoarthritis High incidence of scapholunate ligament injury.