Four Corner carpal Fusion using Medartis plate and scaphoid excision
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Learn the Four Corner carpal 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 carpal 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.
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Question 1 of 15
What ONE of the options is an absolute contra-indication to a Scaphoid excision and Four corner fusion?CorrectIncorrect
Question 2 of 15
Which ONE extensor compartment is breeched first on the approach demonstrated?CorrectIncorrect
Question 3 of 15
Which ONE pair of ligaments does the Berger flap split when opening the dorsal wrist capsule?CorrectIncorrect
Question 4 of 15
Which ONE structure is most at risk when mobilising the ulna tip of the Berger flap?CorrectIncorrect
Question 5 of 15
What ONE option best describes the difference between a type 1 and type 2 lunate?CorrectIncorrect
Question 6 of 15
Which ONE option best describes how the position at which the Capitate is wired to the lunate determined?CorrectIncorrect
Question 7 of 15
Which ONE option best describes the direction the reamer angle when reaming the centre of the 4 bones?CorrectIncorrect
Question 8 of 15
Which ONE joint is the most important to obtain fusion at?CorrectIncorrect
Question 9 of 15
The locking screws can have a variable arc of locking in the plate of how many degrees – choose ONE option?CorrectIncorrect
Question 10 of 15
Which ONE screw position should be sited first in the plate?CorrectIncorrect
Question 11 of 15
Which ONE step is not useful in reducing pain from plaster cast tightness?CorrectIncorrect
Question 12 of 15
Which ONE of these medications is NOT prescribed routinely for this surgery?CorrectIncorrect
Question 13 of 15
Which ONE time period best describes how long the plaster cast is normally left on for post-operatively in most patients?CorrectIncorrect
Question 14 of 15
Which ONE option best describes the non-union rate for this a four corner fusion and scaphoid excision using this plate?CorrectIncorrect
Question 15 of 15
Which ONE option best describe the total arc of flexion and extension is to be expected following a four corner fusion?CorrectIncorrect