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Four-corner bone arthrodesis with dorsal rectangular plate: series and personal techniqueFrom the Plastic and Hand Surgery Department, Réseau Santé Valais, Sion, and Plastic Surgery Department, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland Correspondence: Dr Daniel Espinoza, Service de Chirurgie Plastique, CHUV, Rue Bugnon 46, 1011 Lausanne, Switzerland. Tel.: (+41) 21 3142508. E-mail:daniel.espinoza-kauer{at}chuv.ch. Controversy exists about the best method to achieve bone fusion in four-corner arthrodesis. Thirty-five patients who underwent this procedure by our technique were included in the study. Surgical indications were stage II–III SLAC wrist, stage II SNAC wrist and severe traumatic midcarpal joint injury. Mean follow-up was 4.6 years. Mean active flexion and extension were 34° and 30° respectively; grip strength recovery was 79%. Radiological consolidation was achieved in all cases. The mean DASH score was 23 and the postoperative pain improvement by visual analogue scale was statistically significant. Return to work was possible at 4 months for the average patient. Complications were a capitate fracture in one patient and the need for hardware removal in four cases. Four-corner bone wrist arthrodesis by dorsal rectangular plating achieves an acceptable preservation of range of motion with good pain relief, an excellent consolidation rate and minimal complications.
Key Words: SNAC wrist • SLAC wrist • four-corner arthrodesis • 4CA • partial wrist arthrodesis
This version was published on October
1, 2009 Journal of Hand Surgery (European Volume), Vol. 34, No. 5,
609-613 (2009) |
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