Non-union scaphoid: Four-corner fusion of the wrist.

Abstract:

BACKGROUND:Four-corner fusion of the wrist is an option for management of non-union scaphoid with painful arthritis of the wrist. Various surgical techniques have been devised for four-corner fusion, with inconsistent results. We present our experience of four-corner fusion achieved using a standard H-plate, designed originally for anterior cervical plating. MATERIALS AND METHODS:The study is a retrospective analysis of six cases of painful wrist arthritis resulting from nonunion of scaphoid treated by four-corner fusion, between 1996 and 2004. The average duration of follow-up was 5.8 years. Each patient was evaluated clinically according to the rating scales described by Bach. RESULTS:The mean grip-strength calculated as a percentage of the uninvolved side was 47% pre-operatively, and 74% post- operatively at the final follow-up. The difference between the preoperative and postoperative 'pain ratings' and 'activity ratings' was found to be statistically significant (P<0.001). Mean time to fusion was 16.1 weeks. Dorsal impingement was the most common associated problem. CONCLUSIONS:H-plate, used for four-corner fusion, provides rigid fixation, ensures fusion, and is a good alternative to the available options.

journal_name

Indian J Orthop

authors

Gupta RK,Chauhan DS,Singh H

doi

10.4103/0019-5413.61908

subject

Has Abstract

pub_date

2010-04-01 00:00:00

pages

208-11

issue

2

eissn

0019-5413

issn

1998-3727

journal_volume

44

pub_type

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