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.
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.