title: Results of four-corner arthrodesis using dorsal circular plate fixation.
abstract: OBJECTIVE
  Four-corner arthrodesis with scaphoid excision has been used to reduce pain and preserve functional range of motion for patients with radioscaphoid arthritis. Early results of 4-corner arthrodesis with scaphoid excision using dorsal circular plate fixation are compared with reported results in the literature.
  
  
  METHODS
  We reviewed retrospectively the first 18 four-corner arthrodeses performed with this system by 4 hand surgeons. Two patients had revision surgery for nonunions before the study that were considered failures. Eight patients returned for final radiographs, objective examination, and functional questionnaire. The average follow-up period was 20 months (range, 13-33 mo). These results were compared with reported results in the literature using alternate fixation methods.
  
  
  RESULTS
  Radiographic union was achieved in only 3 wrists. Range of motion was 46% that of the opposite normal wrist and grip strength compared with the opposite wrist was 56%. Five patients would have the procedure again and 6 of 8 have returned to their original employment.
  
  
  CONCLUSIONS
  Four-corner arthrodesis with scaphoid excision using a circular internal fixation plate produced a high number of nonunions. Grip strength and range of motion results also were inferior to those reported in the literature.
authors.affiliation: Greenville Hospital System and Hand Surgery Center, Greenville, SC 29605, USA.
authors.forename: Corey B
authors.initials: CB
authors.lastname: Kendall
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Brown
authors.forename: S John
authors.initials: SJ
authors.lastname: Millon
authors.forename: L Edwin
authors.initials: LE
authors.lastname: Rudisill
authors.forename: John L
authors.initials: JL
authors.lastname: Sanders
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Tanner
mesh_terms: D000328:Adult; D000368:Aged; D001168:Arthritis / Q000601:surgery*; D001174:Arthrodesis / Q000295:instrumentation* / Q000379:methods; D001860:Bone Plates; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000601:surgery; D016896:Treatment Outcome; D014955:Wrist Joint