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Journal of Hand Surgery (European Volume)
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Article

Complications of Circular Plate Fixation for Four-Corner Arthrodesis

M. K. SHINDLE
K. J. BURTON
A. J. WEILAND
B. G. DOMB
S. W. WOLFE

From the Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA

Correspondence: Michael K. Shindle, MD, 310 East 70th St Apt #3L, New York, NY 10021, USA. Tel.: 212 933 4296; fax: 212 606 1477. E-mail:shindlem{at}hss.edu

Four corner arthrodesis is an accepted salvage operation for scapholunate advanced collapse and scaphoid non-union advanced collapse. Circular plates were introduced in 1999 and promoted as a rapid and more stable method for this procedure. A retrospective chart review was performed on all patients who were treated with the Spider Limited Wrist Fusion Plate (Kinetikos Medical Inc., San Diego, CA). Sixteen patients were identified and followed clinically and with X-rays for an average of 16 (range 5–38) months. Nine out of the 16 patients (56%) had complications, including non-union (25%), delayed union (6%), dorsal impingement (25%), radial styloid impingement (6%) and broken screws (13%). The purpose of this study was to compare our complication rate using circular plates with published outcomes using traditional methods of fixation: this study identified a significantly higher complication rate and lower union rate using circular plate fixation for four-corner arthrodesis compared with previously published techniques.

Key Words: circular plate • four corner arthrodesis • non-union • dorsal impingement

Journal of Hand Surgery (European Volume), Vol. 32, No. 1, 50-53 (2007)
DOI: 10.1016/j.jhsb.2006.08.016
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