BACKGROUND: Four-corner fusion has been shown to be a reliable option of treatment of wrist arthritis, but there is no consensus about which implant and surgical procedure should be used in the arthrodesis. The present study aimed to describe a surgical technique using 2 crossed screws as implants, inserted in a retrograde manner, and to demonstrate preliminary results of the use of the technique. METHODS: A retrospective study was conducted using medical records and imaging tests (radiographs and computed tomography) of all 15 patients who underwent a standardized 4-corner fusion technique, between December 2011 and July 2015, in the Department of Hand Surgery of Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, Brazil. We collected data on the following variables: fusion rate, time to fusion, and percentage of patients who had any complications or needed another surgical procedure on the same wrist. RESULTS: All but one patient achieved fusion of arthrodesis. The average time to union was 5.54 months (SD = 3.84). Only the patient who developed nonunion of the 4-corner fusion required another surgery on the same wrist. CONCLUSIONS: The procedure described in this study demonstrated a low complication rate and high fusion rate, and can therefore be considered a reliable surgical technique for 4-corner fusion.
BACKGROUND: Four-corner fusion has been shown to be a reliable option of treatment of wrist arthritis, but there is no consensus about which implant and surgical procedure should be used in the arthrodesis. The present study aimed to describe a surgical technique using 2 crossed screws as implants, inserted in a retrograde manner, and to demonstrate preliminary results of the use of the technique. METHODS: A retrospective study was conducted using medical records and imaging tests (radiographs and computed tomography) of all 15 patients who underwent a standardized 4-corner fusion technique, between December 2011 and July 2015, in the Department of Hand Surgery of Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, Brazil. We collected data on the following variables: fusion rate, time to fusion, and percentage of patients who had any complications or needed another surgical procedure on the same wrist. RESULTS: All but one patient achieved fusion of arthrodesis. The average time to union was 5.54 months (SD = 3.84). Only the patient who developed nonunion of the 4-corner fusion required another surgery on the same wrist. CONCLUSIONS: The procedure described in this study demonstrated a low complication rate and high fusion rate, and can therefore be considered a reliable surgical technique for 4-corner fusion.
Authors: Corey B Kendall; Timothy R Brown; S John Millon; L Edwin Rudisill; John L Sanders; Stephanie L Tanner Journal: J Hand Surg Am Date: 2005-09 Impact factor: 2.230
Authors: Juan González Del Pino; Douglas Campbell; Thomas Fischer; Fiesky Núñez Vázquez; Jesse B Jupiter; Ladislav Nagy Journal: J Wrist Surg Date: 2012-08
Authors: Amre Hamdi; Philippe Poitras; Hakim Louati; Simon Dagenais; Julio Javier Masquijo; Ken Kontio Journal: J Pediatr Orthop Date: 2010-03 Impact factor: 2.324