title: Scaphoid excision with four-corner fusion.
abstract: The scaphoid plays a critical role in maintain-ing normal carpal kinematics. SLAC and SNAC wrist arthritis demonstrate the ramifications ofscaphoid pathology on wrist biomechanics. In the past, symptomatic SLAC or SNAC pathology spelled total wrist arthrodesis. Over the past 20 years there has been a movement toward limited wrist arthrodesis in the treatment of SLAC/SNAC wrists. In the long-term follow-up of four-corner fusions, patient satisfaction is high, patients are able to return to their previous vocation, and wrist function averages 60%-70% of the contralateral wrist. The Spider plate is a recent advancement in the four-corner fusion armamentarium that has thus far shown great promise in respect to fusion rates (100% in the first documented series [36]),functional range of motion, intercarpal stability[37], and patient satisfaction.
authors.affiliation: Department of Orthopaedics, Brown Medical School, University Orthopedics, 2 Dudley Street, Suite 200, Providence, RI 02905, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Enna
authors.forename: Peter
authors.initials: P
authors.lastname: Hoepfner
authors.forename: Arnold-Peter C
authors.initials: AP
authors.lastname: Weiss
mesh_terms: D001168:Arthritis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D001174:Arthrodesis / Q000379:methods*; D006801:Humans; D021361:Scaphoid Bone / Q000601:surgery*; D014955:Wrist Joint / Q000503:physiopathology*