Four-Corner Arthrodesis versus Proximal Row Carpectomy: Risk Factors and Complications Associated with Prolonged Postoperative Opioid Use

Li, Neill Y.; Kuczmarski, Alexander S.; Hresko, Andrew M.; Goodman, Avi D.; Gil, Joseph A.; Daniels, Alan H.

doi:10.1055/s-0040-1715426

Cited by 3 publications

(2 citation statements)

References 28 publications

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“…Risk factors for complications or reoperation following 4CF have previously been studied. Work by van Hernen et al 32 and Li et al 33 identified preoperative narcotic use, history of manual labor, and the absence of AIN/PIN neurectomy to be risk factors for complications or reoperation following 4CF. Neither of these studies addressed the role of oral corticosteroids.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Oral Steroid Use: A Unique Risk Factor in 4-Corner Fusion Compared With Other Wrist Salvage Operations

Newton

Johnson

Daley

et al. 2023

Hand (New York, N,Y.)

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Introduction: Salvage procedures such as proximal row carpectomy, 4-corner fusion, total wrist arthroplasty, and total wrist arthrodesis are commonly used at the end stages of wrist arthritis. These operations have high complication rates, and significant controversy exists regarding the selection of procedure. Long-term oral glucocorticoid therapy has previously been identified as a risk factor for complications in multiple orthopedic procedures. The purpose of this study is to investigate the effect long-term oral preoperative corticosteroid use has on complications after different salvage operations for wrist arthritis. Methods: The National Surgical Quality Improvement Program database was queried to identify patients who underwent proximal row carpectomy, 4-corner fusion, total wrist arthroplasty, or total wrist fusion between 2005 and 2020. Patients were classified by steroid use. Univariate analysis and multivariate logistic regression were used to assess the risk of complications. Results: A total of 1298 patients were identified. Overall, steroid use was found to be independently associated with a higher complication rate. On multivariate analysis of patients who underwent 4-corner fusion, steroid use was found to be associated with higher complication rate and surgical site infection rate. Steroid use was not associated with increased complications in patients who underwent proximal row carpectomy, total wrist arthroplasty, or total wrist fusion when examined individually. Conclusion: Long-term oral corticosteroid therapy was associated with an increased risk of postoperative infections in patients who underwent 4-corner fusion, which was not found in other wrist salvage operations.

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Section: Discussionmentioning

confidence: 99%

Long-Term Oral Steroid Use: A Unique Risk Factor in 4-Corner Fusion Compared With Other Wrist Salvage Operations

Newton

Johnson

Daley

et al. 2023

Hand (New York, N,Y.)

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“…We included multiple patient baseline demographic factors, such as age, sex, BMI, and tobacco use, as these characteristics have been associated with increased or prolonged opioid use after hand procedures. 23 , 25 , 26 , 27 …”

Section: Methodsmentioning

confidence: 99%

Unplanned Postoperative Phone Calls and Electronic Messages for Patients With and Without Opioid Prescriptions After Carpal Tunnel Release

Ozdag,

Manzar,

El Koussaify

et al. 2024

Journal of Hand Surgery Global Online

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Proximal row carpectomy with interposition arthroplasty using both capsular flap and acellular human dermal matrix

Lee,

Seo,

Jung

et al. 2024

BMC Musculoskelet Disord

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Background In cases of wrist arthritis, proximal row carpectomy (PRC) has been widely utilized and shown favorable long-term outcomes. However, its applicability is limited in cases where arthritis extends to the lunate fossa or capitate. Recently, surgical approaches combining various methods of interposition arthroplasty have been introduced to overcome these drawbacks. The purpose of this study was to perform PRC and interposition arthroplasty with dorsal capsule and acellular dermal matrix(ADM),and analyze the clinical outcomes of these procedures. Methods Fourteen cases who underwent PRC and interposition arthroplasty using both dorsal capsular flap and ADM were retrospectively recruited. The researchers assessed the patients’ Visual Analog Scale (VAS) pain score, Disabilities of the Arm, Shoulder and Hand (DASH) scores, range of motion (ROM), retear, and radiocarpal distance (RCD). Results One year post-surgery, both the VAS pain scores, DASH scores, and ROM showed statistically significant improvement compared to before the surgery. Upon reviewing the radiological results, the postoperative mean RCD was 4.8 ± 0.8 mm and one year follow up mean RCD was 3.6 ± 0.5 mm at one year post-surgery. Moreover, in the one year follow-up, there was no observed failure of the allodermis graft in any of the cases. Conclusion The PRC and interposition arthroplasty with ADM demonstrated significantly improved clinical outcomes after surgery, showing a maintain of RCD without graft failure effectively.

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Four-Corner Arthrodesis versus Proximal Row Carpectomy: Risk Factors and Complications Associated with Prolonged Postoperative Opioid Use

Cited by 3 publications

References 28 publications

Long-Term Oral Steroid Use: A Unique Risk Factor in 4-Corner Fusion Compared With Other Wrist Salvage Operations

Long-Term Oral Steroid Use: A Unique Risk Factor in 4-Corner Fusion Compared With Other Wrist Salvage Operations

Unplanned Postoperative Phone Calls and Electronic Messages for Patients With and Without Opioid Prescriptions After Carpal Tunnel Release

Proximal row carpectomy with interposition arthroplasty using both capsular flap and acellular human dermal matrix

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