Midterm Results of Four-Corner Fusion Using Dorsal Circular Plate Fixation

J Wrist Surg. 2018 Jul;7(3):262-266. doi: 10.1055/s-0037-1607072. Epub 2017 Oct 16.

Abstract

Purpose The purpose of this prospective study was to evaluate the results of four-corner fusion using dorsal circular plate. Methods We operated on 20 patients between 2009 and 2011. Results At a mean follow-up period of 30 months (range: 14-62, SD: 16), the mean VAS improved from 8 (range: 4-10, SD: 2) preoperatively to 4 (range: 0-8, SD: 2). Function measured with the DASH score improved from 37 (range: 10-75, SD: 18) to 26 (range: 2.5-64, SD: 19). Eighteen patients in our series showed full consolidation and two patients showed persistent nonunion. Three cases required plate removal due to dorsal impingement. Conclusion Four-corner fusion using dorsal circular plate showed satisfactory results in this study, but it did not show superior results compared with simpler fixation methods mentioned in the literature, such as K-wires or screw fixation. Currently, we are principally using K-wires as a fixation method of choice in our four-corner fusion procedures. Level of Evidence Level II.

Keywords: four-corner fusion; scaphoid nonunion advanced collapse; scapholunate advanced collapse.

Grants and funding

Funding None.