OUTCOMES OF FOUR-CORNER ARTHRODESIS USING THE HUBCAP^TM CIRCULAR PLATE

Abstract

We present results of four-corner carpal arthrodesis with the Acumed Hubcap circular plate performed at our unit. Eight patients underwent eight procedures over five years, for scapholunate advanced collapse (five wrists) and scaphoid non-union advanced collapse (three wrists). Outcomes included range of motion, quickDASH scores, and visual analogue scores for satisfaction. At final follow-up, mean flexion-extension arc was 56°, mean radial-ulnar deviation 29° and mean quickDASH score was 23/100. Mean score for satisfaction was 7.7/10 (77%). Seven out of eight (87.5%) patients said they would have it done again, and would also recommend it to others. Radiological union was achieved in all cases. One screw broke in one arthrodesis without causing symptoms. The functional outcomes with our use of the Hubcap are comparable to those reported in literature to date with other circular plates (e.g. Spider plate). There were no non-unions, which is the main reported complication with these plates.

Ten-Year Minimum Follow-Up of 4-Corner Fusion for SLAC and SNAC Wrist

“…This is consistent with other reported studies despite differences in technique to achieve fusion, such as the spider plate or headless screws. 14,18 This remains above the minimal motion necessary for a functional arc of motion which was described by Ryu et al 20 as being 60° of extension, 54° of flexion, 40° of ulnar deviation, and 17° of radial deviation of the wrist.…”

Clinical outcomes of proximal row carpectomy versus four-corner arthrodesis for post-traumatic wrist arthropathy: a systematic review

“…Studies of 4-CA carried out by various techniques have shown that at up to 10 years follow-up there are generally satisfactory union rates, functional scores, and objective motion, and strength with low complication rates and revision rates to total wrist arthrodesis (Bain and Warts, 2010;Ball and Bergman, 2012;Bedford and Yang, 2010;Goldfarb et al, 2004;Gonzalez del Pino et al, 2012;Khan et al, 2013;Luegmair and Houvet, 2012;Ozyurekoglu and Turker, 2012;Rhee and Shin, 2013). However, there are reports of higher rates of complications with circular plate fixation including non-union, delayed union, and dorsal impingement (Shindle et al, 2007;Skie et al, 2007;Vance et al, 2005).…”

The Complication and Safety Profile of Utilizing Kirschner Wires in Four Corner Fusions

“…19 Since then, other fixation methods have been introduced including locking and nonlocking plates. [20][21][22][23][24][25] With a variety of fixations methods described, there has been no consensus on a superior method. Each of these fixation techniques have their own efficacy and complication profile and need to be examined on their own merits.…”