Four Corner carpal Fusion using Medartis plate and scaphoid excision
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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.
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