BACKGROUND: Scaphoid excision and 4-corner fusion is a standard procedure for advanced carpal collapse. The purpose of this study was to evaluate its effectiveness using a specific designed locking plate of the latest generation. METHODS: Between October 2012 and December 2015, 12 patients underwent this procedure using the Flower (KLS Martin Group, Tuttlingen, Germany) circular locking plate. The surgical technique is standardized. Three patients were affected by a scapholunate advanced collapse and 9 patients by a scaphoid nonunion advanced collapse. All patients underwent a computed tomographic scan to study the real achievement of the fusion. RESULTS: Only 2 patients did not show complete fusion. All the patients with successful fusion returned to previous work and manual activities. CONCLUSIONS: Four-corner arthrodesis with circular locking plate is an alternative surgical treatment for carpal arthritic collapse.
BACKGROUND: Scaphoid excision and 4-corner fusion is a standard procedure for advanced carpal collapse. The purpose of this study was to evaluate its effectiveness using a specific designed locking plate of the latest generation. METHODS: Between October 2012 and December 2015, 12 patients underwent this procedure using the Flower (KLS Martin Group, Tuttlingen, Germany) circular locking plate. The surgical technique is standardized. Three patients were affected by a scapholunate advanced collapse and 9 patients by a scaphoid nonunion advanced collapse. All patients underwent a computed tomographic scan to study the real achievement of the fusion. RESULTS: Only 2 patients did not show complete fusion. All the patients with successful fusion returned to previous work and manual activities. CONCLUSIONS: Four-corner arthrodesis with circular locking plate is an alternative surgical treatment for carpal arthritic collapse.