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satisfied with the surgery were 85%. Mean consolidation was 2.7 months, and less with young patients. Discussion: The results at the follow-up were in terms of: time between the beginning and the surgery; cause (SLAC and luxation are worst); staple malposition; and algodystrophia.Conclusion: Four bones fusion is a good surgical procedure and staple fixation is an easy and sure procedure with good material tolerance.Background: Scaphoid non-union advanced collapse (SNAC) and scapholunate advanced collapse (SLAC) wrists are chronic conditions which require surgical treatment (PRC/four corner arthrodesis) for relief of pain and maintain a functional ROM. Aim: To compare two series of four-corner arthrodeses performed in SLAC/SNAC wrists. In the first group, the arthrodesis was obtained using an annular dorsal plate and screws, in the second we used K-wires and staples. Methods: From 1995 to 2006 we performed 34 fourcorner arthrodesis: an annular spider plate was used in 14 cases, K-wires and staples were used in 20. Twentyeight patients were reviewed: subjective result, R.O.M., strength, radiographic examination were performed. Results: R.O.M. (group I 49% of controlateral, group II 51% of controlateral) and strength (group I av. 29 kg, group II av.31 kg) evaluation resulted as equivalent in the two groups. In the first group seven patients had specific complications related to the chosen device, in the group II only one patients had a major not specific complication. Spider plates showed a specific draw-back consisting of dorsal impingement against the dorsal radial rim; this can lead to hardware mobilisation (six cases), delayed union (three cases) and persisting ulnar pain (four cases). Conclusions: Annular dorsal plates permit a stable four corner carpal arthrodesis. This is preferable to percutaneous K-wiring, due to a reduced risk of

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