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High Fusion Rates with Circular Plate Fixation for Four-corner Arthrodesis of the Wrist

  • Basic Research
  • Published:
Clinical Orthopaedics and Related Research®

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Abstract

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.

Questions/Purposes

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.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Division of Hand and Upper Extremity Surgery, Lenox Hill Hospital, 130 East 77th Street, New York, NY, 10021, USA

    Ben Bedford MD & S. Steven Yang MD, MPH

Authors
  1. Ben Bedford MD
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  2. S. Steven Yang MD, MPH
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Corresponding author

Correspondence to S. Steven Yang MD, MPH.

Additional information

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Bedford, B., Yang, S.S. High Fusion Rates with Circular Plate Fixation for Four-corner Arthrodesis of the Wrist. Clin Orthop Relat Res 468, 163–168 (2010). https://doi.org/10.1007/s11999-009-1139-5

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  • DOI: https://doi.org/10.1007/s11999-009-1139-5

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