Early Experience With (Dry) Arthroscopic 4-Corner Arthrodesis: From a 4-Hour Operation to a Tourniquet Time

Arthroscopic limited intercarpal fusion without bone graft in patients with Kienböck’s disease

“…All surgical scars were almost invisible, and aesthetic outcome was excellent. [17] del Piñal et al [16] described dry arthroscopic 4CF with bone grafting and presented a technique for dry arthroscopic scaphoidectomy and 4CF, which reduces the operative time to less than two hours. In their series, despite the first operation which lasted four hours, the last two operations were completed in one hour and 45 minutes and one hour 55 minutes, respectively.…”

“…No complications were noted. [16] Leblebicioğlu et al [9] presented a study on 16 patients with stage 3A or 3B Kienböck's disease. They were randomized to either open SCF and lunate revascularization (group 1) or fully arthroscopic SCF and capitate pole excision (group 2) groups.…”

“…[12][13][14][15] There are a number of studies about open procedures; however, to our knowledge, only three studies are available in the literature about arthroscopic limited intercarpal fusion. [9,[16][17] Two of these studies used arthroscopic procedure and also graft to enhance intercarpal fusion. In this study, we aimed to present our clinical results obtained in arthroscopic limited intercarpal fusion performed without using bone graft in patients with Kienböck's disease.…”

Dry Wrist Arthroscopy

“…9 Burring out of the scaphoid can be a time-consuming portion of this technique; however, larger portals and thus larger instruments allow quicker excision. After scaphoid resection, further decortication of joints to be arthrodesed continues until healthy cancellous bone is exposed.…”

“…The guidewires are readvanced, position is confirmed using fluoroscopy, and appropriate length cannulated screws are placed for final fixation. 9 Four-corner fusion by DWA is technically challenging and has a steep learning curve, but proponents are satisfied with the ability to achieve complex fixation through minimally invasive surgery. …”