Four Corner Fusion using Medartis plate and scaphoid excision surgical technique


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Learn the Four Corner Fusion using Medartis plate and scaphoid excision surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Four Corner Fusion using Medartis plate and scaphoid excision surgical procedure.

This is a detailed step by step instruction through a Four Corner fusion and scaphoid excision using a dorsal low profile titanium plate from MedartisTM.

This is a salvage operation usually undertaken when the scaphoid fossa is damaged and arthritic most commonly from a Scaphoid non-union advanced collapse (SNAC ) stage 2 and above or Scapholunate advanced collapse (SLAC) stage 2 and above. Rarely it can also be undertaken in the acute setting with complex carpal injuries and dislocations.

Following a period of 6-8 weeks in plaster cast and the rehabilitation it is expected the patient will achieve 30-50% of their normal range of movement. The operation has a non-union rate of around 10%


Author: Mr Mark Brewster FRCS (Tr & Orth)

Institution: The Royal Orthopaedic Hospital, Birmingham, UK.


  • Each operation and the questions associated become named course in the CPD section
  • The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
  • You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
  • The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
  • There are four possible answers of which one is correct (or on occasion more correct) than the others.
  • There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
  • The course is completed once all the lessons are read and quizzes submitted and passed.
  • On successful completion of each quiz you will receive a validated certificate in your CPD folder.
  • Your dashboard also will contain a record of the time you have spent logged onto and using the site.
  • The timer suspends after 5 minutes though if there is no activity.
  • When you restart you will resume at the same point in the module.
  • Once you have completed each quiz you will need to feedback on the module first then click “submit” and your paper will be marked.
    The pass mark is 75%.
  • If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
  • Once these have been read you can re-do just the questions you failed on.
  • Once you have passed the quiz you can return at a future stage & resit .
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Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.

Our content is designed for both Surgeons in independent practice and Surgeons in training.


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