title: Complications of circular plate fixation for four-corner arthrodesis.
abstract: Four corner arthrodesis is an accepted salvage operation for scapholunate advanced collapse and scaphoid non-union advanced collapse. Circular plates were introduced in 1999 and promoted as a rapid and more stable method for this procedure. A retrospective chart review was performed on all patients who were treated with the Spider Limited Wrist Fusion Plate (Kinetikos Medical Inc., San Diego, CA). Sixteen patients were identified and followed clinically and with X-rays for an average of 16 (range 5-38) months. Nine out of the 16 patients (56%) had complications, including non-union (25%), delayed union (6%), dorsal impingement (25%), radial styloid impingement (6%) and broken screws (13%). The purpose of this study was to compare our complication rate using circular plates with published outcomes using traditional methods of fixation: this study identified a significantly higher complication rate and lower union rate using circular plate fixation for four-corner arthrodesis compared with previously published techniques.
authors.affiliation: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA. shindlem@hss.edu
authors.forename: M K
authors.initials: MK
authors.lastname: Shindle
authors.forename: K J
authors.initials: KJ
authors.lastname: Burton
authors.forename: A J
authors.initials: AJ
authors.lastname: Weiland
authors.forename: B G
authors.initials: BG
authors.lastname: Domb
authors.forename: S W
authors.initials: SW
authors.lastname: Wolfe
mesh_terms: D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000295:instrumentation*; D001860:Bone Plates; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D012667:Lunate Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000601:surgery; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000601:surgery*