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Distal Scaphoid Excision

30 citationsUpdated Oct 2026
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Overview

Distal scaphoid resection is a surgical option for treating symptomatic scaphotrapeziotrapezoid (STT) osteoarthritis and symptomatic scaphoid nonunion [1]. It is technically less demanding than arthrodesis and is often offered for patients with isolated STT arthritis and no carpal malalignment due to fewer reported complications [7, 8]. While multiple surgical options exist for STT joint arthrosis, including joint debridement, interposition arthroplasty, replacement arthroplasty, distal scaphoid resection, and arthrodesis, no single approach has clear evidence of superiority [15, 19]. Surgical selection depends on the specific clinical scenario; isolated cases are often managed by distal scaphoid resection or arthrodesis, whereas cases with basal joint arthritis are effectively managed with trapeziectomy and partial trapezoid or distal scaphoid excision [4].

Midterm results for distal pole resection in the treatment of STT-OA and scaphoid nonunion are satisfactory [1, 9]. The procedure provides effective pain relief with improved grip and pinch strengths post-operatively [8]. Arthroscopic resection of the distal pole, with or without implant, represents an excellent treatment option for STT arthritis [5, 10]. This arthroscopic technique has demonstrated an effective and safe profile with fewer complications than open surgery [20].

Biomechanical studies indicate that resection of up to 25% of the distal scaphoid does not significantly influence carpal kinematics, though it induces mild lunate extension deformity [2]. Resection of greater than 3 mm may result in carpal malalignment [6], and any preoperative intracarpal instability (DISI) can be exacerbated by resecting more than 3 or 4 mm of the distal pole [3]. Distal scaphoid excision leads to significant lunate extension through an imbalance in the force couple between the scaphotrapeziotrapezoidal joint and the triquetrumhamate joint [11, 18]. Excision of the dorsal intercarpal ligament further increases lunate extension, suggesting it serves as a secondary stabilizer to the lunocapitate joint [18]. Even after interposition, DISI cannot be avoided, but this carpal deformity has no obvious short-term functional impairment [13]. The procedure carries a risk of inducing midcarpal instability, particularly in cases with underlying chronic asymptomatic dorsal midcarpal instability (CLIP wrist) [29]. Preoperative ruling out of dorsal midcarpal instability is recommended before distal scaphoid resection [29], as STT arthrodesis may be a better option if such instability is present [29]. The surgeon should pay careful attention to the remaining scaphoid to prevent flexor tendon ruptures after distal scaphoid excision [12].

Anatomy & Pathophysiology

Ligamentous Anatomy

The scaphotrapezial ligament consists of three distinct fascicles [23]. A deep fascicle of the scaphotrapezial ligament attaches 3.3 mm from the most distal point of the scaphoid [23].

Biomechanics and Kinematics

Resection of up to 25% of the distal scaphoid did not significantly influence carpal kinematics [2], although it induced mild lunate extension deformity [2]. Any preoperative intracarpal instability (DISI) can be exacerbated by resecting more than 3 or 4 mm of the distal pole of scaphoid [3]. The logical consequence of the removal of the distal portion of the scaphoid is the development of a carpal malalignment, typically in the form of a non-dissociative DISI pattern [17]. Even after interposition, DISI after a distal scaphoidectomy cannot be avoided [13]. However, DISI after a distal scaphoidectomy has no obvious short-term functional impairment [13].

Pathophysiology and Complications

It is likely that degenerative change occurs first and static instability occurs as a secondary phenomenon in the association between STT osteoarthritis and static DISI [33]. DISI was identified in 3 grade 2 wrists (5%) and 44 grade 3 wrists (60%) associated with scaphotrapeziotrapezoid osteoarthritis [24]. Distal scaphoid excision can provoke severe malalignment and midcarpal instability [22]. Severe malalignment and midcarpal instability following distal scaphoid excision can lead to an intercarpal arthrodesis with an outcome potentially worse than STT fusion [22]. Flexor tendon ruptures are a potential complication after distal scaphoid excision for scaphotrapeziotrapezoid osteoarthritis [12]. The surgeon should pay careful attention to the remaining scaphoid to prevent flexor tendon rupture [12].

Surgical Anatomy and Approach

The dorsolateral aspect of the wrist joint is surgically approached with a zig-zag incision for distal scaphoid resection [14]. The dorsal branches of the radial nerve are identified and carefully protected during the dorsal approach to the distal scaphoid [14]. The first, second, and third extensor compartments are identified and partly released from distal to proximal to better mobilize the corresponding tendons [14]. The extensor carpi radialis (longus and brevis) is displaced medially, and the extensor pollicis (longus and brevis) is retracted laterally to expose the dorsolateral capsule [14]. The radial artery runs obliquely at the distal corner of the surgical exposure and must be separated from the capsule and protected [14]. A 2-cm-wide, distally based, capsular flap is fashioned with its base distal to the dorsal edge of the trapezium and trapezoid bones and its proximal end coinciding with the dorsal ridge of the scaphoid [14]. The distal one-fourth of the scaphoid is osteotomized with an osteotome or oscillating saw and removed from the joint [14]. The dorsal capsular flap is reattached over the distal fibers of the transverse intercarpal ligament depending on how much correction of the dorsal intercalated segment instability (DISI) is necessary [14]. A palmar arthroscopic portal to the STT joint can be identified readily because of the palpable surface landmarks [35]. A palmar arthroscopic portal improves the visualization of the STT joint articular surface compared with a dorsal portal because of the orientation of the joint [35].

Classification

Other Considerations: STT joint osteoarthritis accounts for 13% of all wrist arthritis sites [27]. Isolated lesions of the STT joint are rare [27].

Clinical Presentation

Scaphotrapeziotrapezoid (STT) joint osteoarthritis accounts for 13% of all wrist arthritis sites [27]. The pathophysiology typically follows a sequence where degenerative change occurs first, with static instability developing as a secondary phenomenon [33]. Radiographic assessment of the STT joint utilizes a simple, reproducible technique involving pronation, ulnar deviation, and thumb abduction [21].

In studies of radiographic characteristics associated with STT osteoarthritis, dorsal intercalated segmental instability (DISI) was identified in 3 grade 2 wrists (5%) and 44 grade 3 wrists (60%) [24].

Investigations

Plain radiography: Radiographic assessment of carpal instability associated with scaphotrapeziotrapezoid (STT) osteoarthritis identifies dorsal intercalated segmental instability (DISI) in 3 grade 2 wrists (5%) and 44 grade 3 wrists (60%) [24].

Other Considerations: Preoperative ruling out of dorsal midcarpal instability is recommended before distal scaphoid resection for STT osteoarthritis [29]. Preoperative intracarpal instability (DISI) can be exacerbated by resecting more than 3 or 4 mm of the distal pole of the scaphoid [3].

Arthroscopy: A palmar arthroscopic portal to the STT joint can be identified readily because of palpable surface landmarks [35]. This palmar approach improves visualization of the articular surface compared with a dorsal portal due to the orientation of the joint [35].

Treatment

Non-Operative

Nonoperative therapy is recommended as the initial treatment course for scaphotrapeziotrapezoid (STT) arthritis [28].

Operative

Indications: Distal scaphoid excision is a surgical option for isolated STT arthritis [4]. Open excision of the distal pole of the scaphoid is specifically offered for patients with isolated STT arthritis and no carpal malalignment, as this approach is less technically demanding with fewer reported complications [7]. Surgical options for STT arthritis depend on the specific clinical scenario [4].

Surgical Approach / Technique: The dorsolateral aspect of the wrist joint is surgically approached with a zig-zag incision for distal scaphoid excision [14]. During the dorsal approach, the dorsal branches of the radial nerve are identified and carefully protected [14]. At least one-fourth of the distal scaphoid must be resected for full recovery of painless wrist function [17]. Avoidance of any residual STT impingement is the explanation for positive results in distal scaphoid resection compared to cartilage-only resection [17]. The scaphotrapezial ligament consists of three distinct fascicles, including a deep fascicle that attaches 3.3 mm from the most distal point of the scaphoid [23].

Outcomes and Efficacy: The wrist range of motion and the Kapandji score were not significantly reduced postoperatively after surgical treatment of isolated STT osteoarthritis [34]. Arthroscopic debridement can provide good short-term symptomatic relief for isolated scaphotrapeziotrapezoid arthritis with low risk for surgical complications [26].

Other Considerations: There is insufficient evidence to definitively support one surgical approach over another for isolated STT arthritis [7]. None of the surgical options for scaphotrapeziotrapezoidal joint osteoarthritis has clear evidence of superiority [15]. Excision of the dorsal intercarpal (DIC) ligament leads to increased lunate extension after distal scaphoid excision [18]. The DIC ligament serves as a secondary stabilizer to the lunocapitate joint [18]. The removal of the distal portion of the scaphoid leads to the development of a carpal malalignment, typically in the form of a non-dissociative DISI pattern [17]. DISI after a distal scaphoidectomy cannot be avoided, even after interposition [13]. The procedure can provoke severe malalignment and midcarpal instability, leading to an intercarpal arthrodesis with an outcome potentially worse than STT fusion [22]. The surgeon should pay careful attention to the remaining scaphoid to prevent flexor tendon ruptures [12].

Complications

Carpal Instability and Malalignment: Excision of the distal intercarpal (DIC) ligament results in increased lunate extension following distal scaphoid excision [18]. The procedure can provoke severe malalignment and midcarpal instability [22]. When these complications occur, subsequent intercarpal arthrodesis may yield an outcome potentially worse than scaphotrapezial (STT) fusion [22].

Soft Tissue and Vascular Complications: Flexor tendon ruptures represent a potential complication of distal scaphoid excision performed for scaphotrapeziotrapezoid osteoarthritis [12].

Surgical Technique and Approach Considerations: Arthroscopic resection of the distal portion of the scaphoid has demonstrated fewer complications than open surgery [20].

Recovery

Other Considerations: Distal scaphoid excision remains an effective pain relief treatment with improved grip and pinch strengths post-operatively [8]. Arthroscopic resection of the distal pole of the scaphoid, with and without implant, represents an excellent treatment option for this condition [10]. Distal scaphoid excision leads to statistically significant lunate extension, and DIC ligament excision leads to increased lunate extension after distal scaphoid excision, suggesting it serves as a secondary stabilizer to the lunocapitate joint [18].

Key Evidence

  • [L4] The midterm results for distal pole resection of the scaphoid in the treatment of STT-OA and scaphoid nonunion are satisfactory. [1] (10.1177/1558944716660555ix)
  • [L5] Resection of up to 25% of the distal scaphoid did not significantly influence carpal kinematics and induced mild lunate extension deformity. [2] (10.1177/1558944720966717)
  • [Paper] Any preoperative intracarpal instability (DISI) can be exacerbated by resecting more than 3 or 4 mm of the distal pole of scaphoid. [3] (10.1016/j.hansur.2020.12.007)
  • [L5] Surgical options for STT arthritis depend on the specific clinical scenario, with isolated cases often managed by distal scaphoid resection or arthrodesis, while cases with basal joint arthritis are effectively managed with trapeziectomy and partial trapezoid or distal scaphoid excision. [4] (10.5435/jaaos-d-19-00539)
  • [L4] Acceptable results can be obtained by an arthroscopic distal scaphoid resection for STT osteoarthritis. [5] (10.1016/j.jhsa.2016.07.019)
  • [L4] Resection of greater than 3 mm of the distal scaphoid may result in carpal malalignment. [6] (10.1016/j.jhsa.2018.06.021)
  • [L4] There is insufficient evidence to definitively support one approach over the other, but the authors offer open excision of the distal pole of the scaphoid for patients with isolated STT arthritis and no carpal malalignment due to it being less technically demanding with fewer reported complications. [7] (10.1016/j.jhsa.2012.05.007)
  • [L1] Distal scaphoid excision remains an effective pain relief treatment with improved grip and pinch strengths post-operatively, and is technically less demanding than arthrodesis. [8] (10.1142/s0218810417300017)
  • [L4] According to this study, midterm results for distal pole resection of the scaphoid are satisfactory. [9] (10.1177/1558944717735939)
  • [L2] Arthroscopic resection of the distal pole of the scaphoid, with and without implant, represents an excellent treatment option for this condition. [10] (10.1055/s-0036-1572539)
  • [L5] Distal scaphoid excision leads to significant lunate extension through an imbalance in the force couple between the scaphotrapeziotrapezoidal joint and the triquetrumhamate joint. [11] (10.1016/j.jhsa.2012.07.029)
  • [L4] The surgeon should pay careful attention to the remaining scaphoid to prevent this potential complication. [12] (10.1177/1558944717708028)
  • [L4] Our study shows that, even after interposition, DISI after a distal scaphoidectomy cannot be avoided, but this carpal deformity has no obvious short-term functional impairment. [13] (10.1016/j.hansur.2020.03.005)
  • [L4] [14] (10.1097/00130911-199909000-00004)
  • [L5] Surgical options for scaphotrapeziotrapezoidal joint osteoarthritis are numerous, but none has clear evidence of superiority. [15] (10.1177/17531934241295345)
  • [L4] [17] (10.1054/jhsb.1999.0169)
  • [L3] Distal scaphoid excision leads to statistically significant lunate extension, and DIC ligament excision leads to increased lunate extension after distal scaphoid excision, suggesting it serves as a secondary stabilizer to the lunocapitate joint. [18] (10.1016/s0363-5023(11)60034-8)
  • [L5] There are multiple surgical options for STT joint arthrosis, including joint debridement, interposition arthroplasty, replacement arthroplasty, distal scaphoid resection, and arthrodesis. [19] (10.1016/s0749-0712(21)00250-x)
  • [L4] Arthroscopic resection of the distal portion of the scaphoid due to scapho-trapezium-trapezoid osteoarthritis demonstrated an effective and safe technique with less complications than open surgery. [20] (10.1177/1558944719864451)
  • [L5] A simple, reproducible technique for assessing the scaphotrapeziotrapezoid joint radiographically is described. [21] (10.1097/bth.0000000000000199)
  • [L4] The procedure can provoke severe malalignment and midcarpal instability, leading to an intercarpal arthrodesis with an outcome potentially worse than STT fusion. [22] (10.1177/1753193408098903)
  • [L5] The scaphotrapezial ligament consists of three distinct fascicles, including a deep fascicle that attaches 3.3 mm from the most distal point of the scaphoid. [23] (10.1016/j.jhsa.2025.09.010)
  • [L4] DISI was identified in 3 grade 2 wrists (5%), and 44 grade 3 wrists (60%). [24] (10.1016/j.jhsa.2025.11.018)
  • [L4] Arthroscopic debridement can provide good short-term symptomatic relief for isolated scaphotrapeziotrapezoid arthritis with low risk for surgical complications. [26] (10.1016/s0363-5023(03)00368-x)
  • [Paper] [27] (10.1016/j.hcl.2011.05.001)
  • [L4] Nonoperative therapy is recommended as the initial treatment course. [28] (10.1016/j.hcl.2008.03.002)
  • [L5] Distal scaphoid resection for STT osteoarthritis carries a risk of inducing midcarpal instability, particularly in cases with underlying chronic asymptomatic dorsal midcarpal instability (CLIP wrist); preoperative ruling out of dorsal midcarpal instability is recommended, and STT arthrodesis may be a better option if instability is present. [29] (10.1177/1753193409356219)
  • [L4] It is likely that the degenerative change occurs first and the static instability occurs as a secondary phenomenon. [33] (10.1016/0266-7681(94)90084-1)
  • [L4] The wrist range of motion (ROM) and the Kapandji score were not significantly reduced postoperatively. [34] (10.1016/j.hansur.2019.11.005)
  • [L5] A palmar arthroscopic portal to the STT joint can be identified readily because of the palpable surface landmarks, improves the visualization of its articular surface compared with a dorsal portal because of the orientation of the joint, is safe, and provides a second portal through which therapeutic interventions may be considered. [35] (10.1016/s0363-5023(03)00253-3)

See Also

References

[1] Resection of the Distal Pole of the Scaphoid in Symptomatic Scaphotrapeziotrapezoid Osteoarthritis and Symptomatic Scaphoid Nonunion. HAND. 2016. DOI: 10.1177/1558944716660555ix

[2] How Much Scaphoid Can be Safely Resected? A Biomechanical Analysis of the Effects of Distal Scaphoid Resection. HAND. 2020. DOI: 10.1177/1558944720966717

[3] Scaphotrapeziotrapezoid osteoarthritis: From the joint to the patient. Hand Surgery and Rehabilitation. 2021. DOI: 10.1016/j.hansur.2020.12.007

[4] Surgical Management of Scaphotrapeziotrapezoid Arthritis. Journal of the American Academy of Orthopaedic Surgeons. 2020. DOI: 10.5435/jaaos-d-19-00539

[5] Arthroscopic Distal Scaphoid Resection for Scaphotrapeziotrapezoidal Osteoarthritis. The Journal of Hand Surgery. 2016. DOI: 10.1016/j.jhsa.2016.07.019

[6] Arthroscopic Distal Scaphoid Resection for Isolated Scaphotrapeziotrapezoid Osteoarthritis. The Journal of Hand Surgery. 2019. DOI: 10.1016/j.jhsa.2018.06.021

[7] Scaphotrapezium-Trapezoid Arthrosis. The Journal of Hand Surgery. 2012. DOI: 10.1016/j.jhsa.2012.05.007

[8] Scaphotrapeziotrapezoidal Joint Osteoarthritis: A Systematic Review of Surgical Treatment. The Journal of Hand Surgery (Asian-Pacific Volume). 2017. DOI: 10.1142/s0218810417300017

[9] Distal Pole Resection of the Scaphoid for the Treatment of Scaphotrapeziotrapezoid Osteoarthritis. HAND. 2017. DOI: 10.1177/1558944717735939

[10] Arthroscopic Resection of Distal Pole of the Scaphoid for Scaphotrapeziotrapezoid Joint Arthritis: Comparison between Simple Resection and Implant Interposition. Journal of Wrist Surgery. 2016. DOI: 10.1055/s-0036-1572539

[11] The Effect of the Dorsal Intercarpal Ligament on Lunate Extension After Distal Scaphoid Excision. The Journal of Hand Surgery. 2012. DOI: 10.1016/j.jhsa.2012.07.029

[12] Flexor Tendon Ruptures After Distal Scaphoid Excision for Scaphotrapeziotrapezoid Osteoarthritis. HAND. 2017. DOI: 10.1177/1558944717708028

[13] Does the DISI matter after distal scaphoidectomy with tendon interposition for STT osteoarthritis?. Hand Surgery and Rehabilitation. 2020. DOI: 10.1016/j.hansur.2020.03.005

[14] Distal Scaphoid Excision in Scaphoid-Trapezium-Trapezoid Arthritis. Techniques in Hand & Upper Extremity Surgery. 1999. DOI: 10.1097/00130911-199909000-00004

[15] Surgical options and outcomes for treatment of osteoarthritis of the scaphotrapeziotrapezoidal joint. Journal of Hand Surgery (European Volume). 2025. DOI: 10.1177/17531934241295345

[17] Resection of the Distal Scaphoid for Scaphotrapeziotrapezoid Osteoarthritis. Journal of Hand Surgery. 1999. DOI: 10.1054/jhsb.1999.0169

[18] DIC Ligament Prevents Increased DISI after Distal Scaphoid Excision. The Journal of Hand Surgery. 2011. DOI: 10.1016/s0363-5023(11)60034-8

[19] THE SURGICAL TREATMENT OF SCAPHOTRAPEZIOTRAPEZOID OSTEOARTHRITIS. Hand Clinics. 2001. DOI: 10.1016/s0749-0712(21)00250-x

[20] Arthroscopic Distal Scaphoid Resection for Scapho-Trapezium-Trapezoid Arthritis. HAND. 2019. DOI: 10.1177/1558944719864451

[21] Obtaining a Reliable Scaphotrapeziotrapezoid Radiograph: Pronation, Ulnar Deviation, and Thumb Abduction. Techniques in Hand & Upper Extremity Surgery. 2018. DOI: 10.1097/bth.0000000000000199

[22] Midcarpal instability after excision arthroplasty for scapho-trapezial-trapezoid (STT) arthritis. Journal of Hand Surgery (European Volume). 2009. DOI: 10.1177/1753193408098903

[23] Anatomy of the Scaphotrapezial Ligament Complex and its Implications for Distal Scaphoid Resection. The Journal of Hand Surgery. 2026. DOI: 10.1016/j.jhsa.2025.09.010

[24] Radiographic Characteristics of Carpal Instability Associated With Scaphotrapeziotrapezoid Osteoarthritis. The Journal of Hand Surgery. 2026. DOI: 10.1016/j.jhsa.2025.11.018

[26] Results of arthroscopic debridement for isolated scaphotrapeziotrapezoid arthritis. The Journal of Hand Surgery. 2003. DOI: 10.1016/s0363-5023(03)00368-x

[27] Arthroscopic Treatment of Scaphotrapeziotrapezoid Osteoarthritis. Hand Clinics. 2011. DOI: 10.1016/j.hcl.2011.05.001

[28] Treatment of Scaphotrapezio-Trapezoid Arthritis. Hand Clinics. 2008. DOI: 10.1016/j.hcl.2008.03.002

[29] Re: Corbin C, Warwick D. Midcarpal instability after excision arthroplasty for scapho-trapezial-trapezoid (STT) arthritis, J Hand Surg Eur. 2009, 34: 537–8. Journal of Hand Surgery (European Volume). 2010. DOI: 10.1177/1753193409356219

[33] An Association between Scapho-Trapezio-Trapezoid Osteoarthritis and Static Dorsal Intercalated Segment Instability. Journal of Hand Surgery. 1994. DOI: 10.1016/0266-7681(94)90084-1

[34] Functional outcomes after surgical treatment of isolated scaphotrapeziotrapezoid osteoarthritis: Retrospective single-center 24-case series. Hand Surgery and Rehabilitation. 2020. DOI: 10.1016/j.hansur.2019.11.005

[35] Scaphotrapezial joint arthroscopy: a palmar portal. The Journal of Hand Surgery. 2003. DOI: 10.1016/s0363-5023(03)00253-3

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3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

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