Results of four-corner arthrodesis using dorsal circular plate fixation.
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.
Kendall
Corey B
CB
Greenville Hospital System and Hand Surgery Center, Greenville, SC 29605, USA.
Brown
Timothy R
TR
Millon
S John
SJ
Rudisill
L Edwin
LE
Sanders
John L
JL
Tanner
Stephanie L
SL
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