High fusion rates with circular plate fixation for four-corner arthrodesis of the wrist.
BACKGROUND
Scaphoid excision and four-corner fusion is commonly performed to reconstruct advanced scapholunate collapse and scaphoid nonunion with collapse. Metallic plates were introduced for achieving fixation of the four carpal bones. Although the developer reported high rates of fusion, several other early reports of circular plate fixation suggest higher complication rates and inferior outcomes compared with traditional fixation techniques.


OBJECTIVE
To clarify the controversy in the literature we determined the fusion rates, complications, and functional outcomes of patients having circular plate fixation for four-corner fusion.


METHODS
We retrospectively reviewed 15 patients treated for radioscaphoid arthritis with four-corner fusion using circular plate fixation. The minimum followup was 11 months (mean, 22 months; range, 11-39 months).


RESULTS
Radiographic union was achieved by all 15 patients. There was only one postoperative complication. ROM was 71% and grip strength was 78% of the opposite normal side.


CONCLUSIONS
Our results compare favorably with those using traditional fixation techniques. ROM measurements seem superior to those reported in the literature.


METHODS
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Bedford
Ben
B
Department of Orthopedic Surgery, Division of Hand and Upper Extremity Surgery, Lenox Hill Hospital, 130 East 77th Street, New York, NY 10021, USA.
Yang
S Steven
SS
D001174:Arthrodesis / Q000295:instrumentation* / Q000379:methods / Q000534:rehabilitation; D001860:Bone Plates; D001863:Bone Screws; D001864:Bone Wires; D005260:Female; D005471:Fluoroscopy; D018737:Hand Strength; D006801:Humans; D007593:Joint Instability; D008297:Male; D008875:Middle Aged; D016348:Osseointegration; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D010146:Pain; D011183:Postoperative Complications; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*