Four corner arthrodesis limited to the centre using a scaphoid one piece graft and a dorsal circular plate

We present 20 patients, who had a four corner arthrodesis, from July 2006 to March 2008, using a dorsal circular plate, to treat scaphoid nonunion and scapholunate dissociation with advanced collapse (SNAC, SLAC). The surgical technique was a fusion restricted to the central area filled with one pie...

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Bibliographic Details
Published in:The Journal of hand surgery, European volume European volume, 2010-01, Vol.35 (1), p.38-42
Main Authors: Mantovani, G., Mathoulin, C., Fukushima, W. Y., Cho, A. B., Aita, M. A., Argintar, E.
Format: Article
Language:English
Subjects:
Adult
Arthrodesis - methods
Biological and medical sciences
Bone Plates
Diseases of the osteoarticular system
Female
Fractures, Ununited - surgery
Humans
Injuries of the limb. Injuries of the spine
Lunate Bone - injuries
Lunate Bone - surgery
Male
Medical sciences
Middle Aged
Miscellaneous. Osteoarticular involvement in other diseases
Orthopedic surgery
Scaphoid Bone - transplantation
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Traumas. Diseases due to physical agents
Wrist Injuries - surgery
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Summary:We present 20 patients, who had a four corner arthrodesis, from July 2006 to March 2008, using a dorsal circular plate, to treat scaphoid nonunion and scapholunate dissociation with advanced collapse (SNAC, SLAC). The surgical technique was a fusion restricted to the central area filled with one piece of cancellous bone graft taken from the excised scaphoid. Wrist motion, grip strength, and Disabilities of Arm Shoulder and Hand (DASH) score improved after surgery at a mean follow-up of 20.2 months. Fusion occurred in 19/20 patients. Two patients (10%) had persistent pain. The rest had a good clinical result. We found that four-corner fusion using a dorsal circular plate using the specific technical modifications was successful.
ISSN:1753-1934
2043-6289
DOI:10.1177/1753193409349905