Four-corner fusion of the wrist: clinical and radiographic outcome of 31 patients

Mavrogenis, Andreas F.; Flevas, Dimitrios A; Raptis, Konstantinos; Megaloikonomos, Panayiotis D.; Igoumenou, Vasilios G.; Antoniadou, Thekla; Dimopoulos, Leonidas; Antonopoulos, D; Spyridonos, Sarantis

doi:10.1007/s00590-016-1824-5

Cited by 15 publications

(11 citation statements)

References 40 publications

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“…27,31 Our overall patient satisfaction compares decently with the prevalences of 60 to 100% that have been cited. 1,11,14,22 Both of the dissatisfied patients underwent a reoperation, one for ruptured tendon reconstruction and one for scaphoid remnant removal. Additionally, they were among the first four to be operated on where most of the complications were observed.…”

Section: Discussionmentioning

confidence: 99%

The Learning Curve and Pitfalls of Arthroscopic Four-Corner Arthrodesis

2019

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Background Midcarpal “four-corner” wrist arthrodesis may be done from an open arthrotomy or arthroscopically. Purpose This study aimed to examine the results of the recently described arthroscopic four-corner arthrodesis and whether the procedure seems to have any merit compared with the open technique. Patients and Methods We retrospectively identified eight patients with nine cases of arthroscopic four-corner arthrodesis performed at our institution, 2014 to 2017. The underlying pathologies were scapholunate advanced collapse (n = 6), Preiser's disease (n = 1), radioscaphoid (n = 1), or capitolunar (n = 1) osteoarthritis. Osteosynthesis was done with cannulated compression screws. Results Operating time for the first surgery was 198 minutes while the final one lasted 132 minutes. All patients achieved fusion. Three patients required a reoperation; one for screw malposition with screw removal, one for tendon reconstruction and screw removal due to a tendon injury induced by a retracted screw, and one for scaphoid impingement with removal of the scaphoid remnants. One patient experienced a probable superficial radial nerve injury. The follow-up time was 5 to 16 months. Conclusion The arthroscopic approach is technically extremely demanding and has a learning curve. Thorough resection of the scaphoid is recommended to avoid potential impingement. Level of Evidence This is a level IV, retrospective case series.

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Section: Discussionmentioning

confidence: 99%

The Learning Curve and Pitfalls of Arthroscopic Four-Corner Arthrodesis

2019

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“…One of these is the study published by Mavrogenis et al They compared the long-term results of patients with 4 CF with either K-wires, headless compressive screws or a circular plate [40]. They reported patient’s satisfaction and improvement of pre-operative pain level, range of motion and grip strength in all groups.…”

Section: Discussionmentioning

confidence: 99%

“…The partial fused wrists were treated in two cases with K-wire MCA and in one case with a circular plate. The overall complication rate is given with 10% of total: 2 patients with the circular plate (1 case of impingement and 1 case of regional pain syndrome) and one patient after K-wire/ headless compression screws fixation (impingement) [40]. …”

Section: Discussionmentioning

confidence: 99%

Four-corner arthrodesis of the wrist using Variable Angle Locking Compression Intercarpal Fusion Plate (VA LCP ICF Plate; Synthes ® ): pre- and postoperative radiological analysis and clinical outcome in long-term evaluation

Eder

Scheller

Schwab

et al. 2019

GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW; 8:Doc15

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“…The main goal of these procedures is to alleviate pain. [70][71][72][73][74][75] Chronic scaphoid nonunion with SNAC wrist and secondary OA often requires salvage procedures, such as limited fusion, scaphoid excision with four-corner fusion (4CF), or a proximal row carpectomy with variable reported outcomes. 27,70 The 4CF is a limited wrist fusion technique frequently used to treat primary or secondary OA and midcarpal instability to help with pain relief, improve grip strength, and preserve the range of motion.…”

Section: Arthrodesismentioning

confidence: 99%

“…Scaphoid replacement with a silicone implant, used in the past, resulted in complications, such as implant migration, silicone synovitis, and osteolysis, and it was subsequently abandoned. 71 Complications associated with 4CF include nonunion, hardware prominence, or fracture causing pain (►Fig. 13), secondary OA of the radiolunate joint, and nerve injuries; each of these has highly variable reported ranges of incidence.…”

Section: Arthrodesismentioning

confidence: 99%

Posttreatment Imaging of the Wrist and Hand: Update 2022

Taljanovic

Omar

Weaver

et al. 2022

Semin Musculoskelet Radiol

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Common indications for surgical procedures of the wrist and hand include acute fractures or fracture-dislocations; nonunited fractures; posttraumatic, degenerative, and inflammatory arthritides and tendinopathies; injuries to tendons, ligaments, and the triangular fibrocartilage complex; and entrapment neuropathies. Soft tissue or osseous infections or masses may also need surgical treatment. Several of these procedures require surgical hardware placement, and most entail clinical follow-up with periodic imaging. Radiography should be the first imaging modality in the evaluation of the postoperative wrist and hand. Computed tomography, magnetic resonance imaging, diagnostic ultrasonography, and occasionally nuclear medicine studies may be performed to diagnose or better characterize suspected postoperative complications. To provide adequate evaluation of postoperative imaging of the wrist and hand, the interpreting radiologist must be familiar with the basic principles of these surgical procedures and both the imaging appearance of normal postoperative findings as well as the potential complications.

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Four-corner fusion of the wrist: clinical and radiographic outcome of 31 patients

Cited by 15 publications

References 40 publications

The Learning Curve and Pitfalls of Arthroscopic Four-Corner Arthrodesis

The Learning Curve and Pitfalls of Arthroscopic Four-Corner Arthrodesis

Four-corner arthrodesis of the wrist using Variable Angle Locking Compression Intercarpal Fusion Plate (VA LCP ICF Plate; Synthes ® ): pre- and postoperative radiological analysis and clinical outcome in long-term evaluation

Posttreatment Imaging of the Wrist and Hand: Update 2022

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