Four-corner fusion: comparison of patient satisfaction and functional outcome of conventional K-wire technique vs. a new locking plate

Hernekamp, Jochen-Frederick; Reinecke, Alexander; Neubrech, Florian; Bickert, Berthold; Kneser, Ulrich; Kremer, Thomas

doi:10.1007/s00402-016-2416-x

Cited by 23 publications

(18 citation statements)

References 20 publications

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“…In our series of four-corner arthrodesis for SLAC and SNAC wrists using the APTUS® four-corner fusion plate, pain, function, and grip strength were significantly improved at a follow-up of 4 to 9 years. These clinical outcomes are consistent with those of similar published series with locking plates (Elgammal et al., 2018; Hernekamp et al., 2016; Le Corre et al., 2015; Luegmair and Houvet, 2012; Reissner et al., 2018; Rhee and Shin, 2013; Rimokh et al., 2020; Rudnik et al., 2014). The postoperative VAS score for pain ranged from 1 to 4 (Hernekamp et al., 2016), and the grip strength was from 54% or 77% of the contralateral side (Rudnik et al., 2014; Tielemans et al., 2017).…”

Section: Discussionsupporting

confidence: 89%

“…Various other fixation methods have been proposed for four-corner arthrodesis, including K-wires, screws, staples, or non-locking plates (De Smet et al., 2006; Vance et al., 2005), and several comparative studies have been published. Hernekamp et al. (2016) reported no significant differences between the APTUS® dorsal locking plate and K-wires with respect to pain, grip strength, active ROM, and fusion incidence.…”

Section: Discussionmentioning

confidence: 91%

“…Fixation can be achieved with Kischner (K)-wires, screws, staples, and locking or non-locking plates. There is no consensus on the optimal fixation method (Ball and Bergman, 2012; Bedford and Yang, 2010; Chaudhry et al., 2016; De Smet et al., 2006; Hernekamp et al., 2016; Pauchard et al., 2014). Locking plate fixation may require shorter postoperative immobilization, which allows rehabilitation to start earlier and aims to obtain a better range of motion (ROM) (Kraisarin et al., 2011).…”

Section: Introductionmentioning

confidence: 99%

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Four-corner arthrodesis with a dorsal locking plate: 4–9-year follow-up

Athlani

Sabau

Pauchard³

et al. 2020

J Hand Surg Eur Vol

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We report the outcomes of four-corner arthrodesis for advanced wrist collapse in 50 patients (51 wrists) using a dorsal locking plate. At a mean follow-up of 6 years (range 4–9), pain was significantly reduced and wrist function was significantly improved compared with preoperative status. After four-corner arthrodesis, grip strength was 80% of the contralateral side, and wrist motion averaged 50° flexion–extension and 30° radioulnar deviation. Immobilization time was 5 weeks (4–6) and sick-leave was 3 months (2–5) following surgery. There were seven nonunions (14%) that underwent repeat arthrodesis. Three wrists were later converted to total arthrodesis due to persisting pain. Radiographic dorsal impingement was found in five wrists after four-corner arthrodesis and did not require reoperation. The outcomes appear not remarkably different from those reported using other fixation methods other than an apparent earlier return to activities. Level of evidence: IV

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Four-corner arthrodesis with a dorsal locking plate: 4–9-year follow-up

Athlani

Sabau

Pauchard³

et al. 2020

J Hand Surg Eur Vol

View full text Add to dashboard Cite

show abstract

“…Altogether three out of eight wrists (37.5%) required a reoperation in comparison to 0 to 44% reported in open surgeries 1,22,33,[35][36][37][38] and 8 to 20% reported in earlier A-PWAs. 27,31 Our overall patient satisfaction compares decently with the prevalences of 60 to 100% that have been cited.…”

Section: Discussionmentioning

confidence: 67%

The Learning Curve and Pitfalls of Arthroscopic Four-Corner Arthrodesis

2019

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Background Midcarpal “four-corner” wrist arthrodesis may be done from an open arthrotomy or arthroscopically. Purpose This study aimed to examine the results of the recently described arthroscopic four-corner arthrodesis and whether the procedure seems to have any merit compared with the open technique. Patients and Methods We retrospectively identified eight patients with nine cases of arthroscopic four-corner arthrodesis performed at our institution, 2014 to 2017. The underlying pathologies were scapholunate advanced collapse (n = 6), Preiser's disease (n = 1), radioscaphoid (n = 1), or capitolunar (n = 1) osteoarthritis. Osteosynthesis was done with cannulated compression screws. Results Operating time for the first surgery was 198 minutes while the final one lasted 132 minutes. All patients achieved fusion. Three patients required a reoperation; one for screw malposition with screw removal, one for tendon reconstruction and screw removal due to a tendon injury induced by a retracted screw, and one for scaphoid impingement with removal of the scaphoid remnants. One patient experienced a probable superficial radial nerve injury. The follow-up time was 5 to 16 months. Conclusion The arthroscopic approach is technically extremely demanding and has a learning curve. Thorough resection of the scaphoid is recommended to avoid potential impingement. Level of Evidence This is a level IV, retrospective case series.

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“…The study group of Hernekamp et al reported of no statistical differences comparing patients with K-wire 4 CF and locking plate 4 CF [41]. …”

Section: Discussionmentioning

confidence: 99%

Four-corner arthrodesis of the wrist using Variable Angle Locking Compression Intercarpal Fusion Plate (VA LCP ICF Plate; Synthes ® ): pre- and postoperative radiological analysis and clinical outcome in long-term evaluation

Eder

Scheller

Schwab

et al. 2019

GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW; 8:Doc15

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Four-corner fusion: comparison of patient satisfaction and functional outcome of conventional K-wire technique vs. a new locking plate

Abstract: Both techniques for four-corner fusion have similar healing rates. Using the more expensive locking implant avoids a second operation for K-wire removal, but no statistical differences were detected in functional outcome as well as in patient satisfaction when compared to SOC.

Cited by 23 publications

References 20 publications

Four-corner arthrodesis with a dorsal locking plate: 4–9-year follow-up

Four-corner arthrodesis with a dorsal locking plate: 4–9-year follow-up

The Learning Curve and Pitfalls of Arthroscopic Four-Corner Arthrodesis

Four-corner arthrodesis of the wrist using Variable Angle Locking Compression Intercarpal Fusion Plate (VA LCP ICF Plate; Synthes ® ): pre- and postoperative radiological analysis and clinical outcome in long-term evaluation

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