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Journal of Hand Surgery (European Volume)
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Article

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

G. Mantovani, Dr*, C. Mathoulin, W. Y. Fukushima, A. B. Cho, M. A. Aita, and E. Argintar

Faculdade de Medicina do ABC, Orthopaedic Department, Hand Surgery Group, Santo Andre, Sao Paulo, Brazil

* To whom correspondence should be addressed. E-mail: mantaray2{at}uol.com.br.


  Abstract

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.

First published on October 20, 2009
Journal of Hand Surgery (European Volume) 2009, doi:10.1177/1753193409349905
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