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Study cites four-corner arthrodesis as effective treatment for arthritic wrists
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Recently published data indicated four-corner arthrodesis with circular plate fixation is effective for the treatment of wrists with degenerative arthritis.
Researchers retrospectively evaluated 36 male patients with a mean age of 48 years who underwent four-corner arthrodesis for either scapholunate advanced collapse or scaphoid nonunion advanced collapse. Patients were followed for an average for 56 months. Investigators evaluated functional outcomes including VAS pain score, range of motion, grip strength and DASH score. A handheld goniometer was used to measure wrist motion.
Radiographs were evaluated for arthrosis presence, nonunion, hardware failure and dorsal impingement. Data also collected included work status, bone union status, complications and reoperations.
Results showed mean VAS score preoperatively was 7 and 1 postoperatively. Investigators noted the average wrist range of motion in extension, flexion, ulnar radiation and radial deviation was 42°, 36°, 15° and 12°, respectively. Preoperatively, the mean grip strength was 34 kg, postoperatively it was 50 kg and contralaterally it was 56 kg.
According to radiographic results, 35 patients achieved union. Investigators found one patient had nonunion and required revision surgery. The mean capitolunate angle preoperatively and postoperatively was 39° and 9°, respectively. In three cases, the investigators observed one or two broken screws. Researchers found hardware dorsal impingement in six cases.
The mean DASH score was 24, and patient satisfaction overall was 70%. In addition, the investigators noted a poor correlation for flexion and extension with the capitate-lunate angle. ‒ by Monica Jaramillo
Disclosures: The researchers report no relevant financial disclosures.
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