The never-ending battle between proximal row carpectomy and four corner arthrodesis: A systematic review and meta-analysis for the final verdict

Ahmadi, Ali; Duraku, Liron S.; Hundepool, Caroline A.; Selles, Ruud W.; Zuidam, J. Michiel

doi:10.1016/j.bjps.2021.09.076

Cited by 19 publications

(14 citation statements)

References 27 publications

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“…This score was chosen based on the approximate mean for previous reviews on 4CA and PRC. 1,4,8,9 The Wagner et al 6 article was not included in this analysis due to a lack of individual case scores.…”

Section: Discussionmentioning

confidence: 99%

Age Considerations in Four-Corner Arthrodesis and Proximal Row Carpectomy: A Review

Heifner,

Karadimas,

DeVito

et al. 2023

J Wrist Surg

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Purpose Although indications for four-corner arthrodesis (4CA) and proximal row carpectomy (PRC) are not completely aligned, the surgeon is often tasked with deciding between these options which vary in the surgical technique and complication profile. Patient age is often discussed as a determining factor for treatment; however, outcome data for these procedures are rarely stratified by patient age. Our objective was to perform a systematic review on the age-specific outcomes for 4CA and PRC. Methods A PubMed database search for 4CA and PRC was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The inclusion criteria required individual case reporting of patient age, surgical intervention, and appropriate outcome measures. The data were stratified by procedure and by patients older and younger than 45 years. Results Within the 4CA group, the relative risk for a disabilities of the arm, shoulder, and hand (DASH) score above 30 was 1.94 (95% confidence interval, 1.1–3.67) in patients over 45 years compared with patients under 45 years. Within the PRC group, grip strength as a percentage of the contralateral side was higher in the over 45 age group (mean 75%) compared to the under 45 age group (mean 61%) but did not reach the level of significance. Conclusion Despite satisfactory results for 4CA in aggregate, the distribution of scores indicates the need for setting expectations when treating younger adult patients with 4CA. The current results demonstrate increased disability based on DASH score following 4CA in patients under 45 years compared with patients over 45 years. Although outcomes were comparable between younger and older adults following PRC, recovery of grip strength may occur less frequently in younger adults. Level of evidence IV systematic review.

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Section: Discussionmentioning

confidence: 99%

Age Considerations in Four-Corner Arthrodesis and Proximal Row Carpectomy: A Review

Heifner,

Karadimas,

DeVito

et al. 2023

J Wrist Surg

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“…Thus, a wide range of limited wrist arthrodesis techniques with specially designed osteosynthesis material were developed. Scaphotrapezium-trapezoid arthrodesis, scaphocapitate arthrodesis, radioscapholunate arthrodesis, scapholunocapitate arthrodesis, and four-corner (capitate–lunate–hamate–triquetrum) arthrodesis, for instance, involve a more differentiated approach; hence, fusion is only performed in arthritically degenerated wrist joints while motion is maintained in a portion of the wrist which is not affected by OA itself [ 2 , 25 , 26 ]. In this regard, the sequence of chondral destruction caused by SLAC and SNAC wrist has been previously described in four stages: these areas are generally quite similar within these two degenerative wrist diseases [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Scaphotrapezium-trapezoid arthrodesis, scaphocapitate arthrodesis, radioscapholunate arthrodesis, scapholunocapitate arthrodesis, and four-corner (capitate–lunate–hamate–triquetrum) arthrodesis, for instance, involve a more differentiated approach; hence, fusion is only performed in arthritically degenerated wrist joints while motion is maintained in a portion of the wrist which is not affected by OA itself [ 2 , 25 , 26 ]. In this regard, the sequence of chondral destruction caused by SLAC and SNAC wrist has been previously described in four stages: these areas are generally quite similar within these two degenerative wrist diseases [ 26 ]. While four-corner arthrodesis is a widespread surgery used for these two indications, proximal row carpectomy renders another more cost-effective and less surgically demanding surgical technique [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…In this regard, the sequence of chondral destruction caused by SLAC and SNAC wrist has been previously described in four stages: these areas are generally quite similar within these two degenerative wrist diseases [ 26 ]. While four-corner arthrodesis is a widespread surgery used for these two indications, proximal row carpectomy renders another more cost-effective and less surgically demanding surgical technique [ 26 , 27 ]. However, predicted loss of motion and subsequent OA of the more stressed joints are well-known drawbacks of these two surgical methods [ 24 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…While four-corner arthrodesis is a widespread surgery used for these two indications, proximal row carpectomy renders another more cost-effective and less surgically demanding surgical technique [ 26 , 27 ]. However, predicted loss of motion and subsequent OA of the more stressed joints are well-known drawbacks of these two surgical methods [ 24 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Total Wrist Arthroplasty for Posttraumatic Wrist Osteoarthritis: A Cohort Study Comparing Three Indications

Holzbauer

Mihalic

Pollak

et al. 2022

Life

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Scapholunate ligament ruptures and scaphoid nonunion with consecutive advanced collapse (SLAC and SNAC wrists) as well as intra-articular distal radius fractures (DRF) are prone to cause posttraumatic wrist osteoarthritis. The aim of this study was to compare the outcomes of these indications for total wrist arthroplasty. We included 13, 11, and 8 patients with an overall mean age of 60 ± 9 years in the SLAC, SNAC, and DRF cohort, respectively. After an average follow-up period of 6 ± 3 years, we found no difference between our groups regarding pain levels and functional scores, although these parameters significantly improved compared to preoperative parameters. Complication and revision rates revealed no significant difference. However, significantly higher extension, arc of range of motion values in the flexion-extension, as well as in radial-ulnar deviation plain were detected in the SLAC compared to the DRF group. Finally, TWA proved to show a beneficial performance in all three investigated indications.

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SLAC Wrist: Midcarpal Fusion

Frix,

Gaston

2024

Carpal Instability

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The never-ending battle between proximal row carpectomy and four corner arthrodesis: A systematic review and meta-analysis for the final verdict

Cited by 19 publications

References 27 publications

Age Considerations in Four-Corner Arthrodesis and Proximal Row Carpectomy: A Review

Age Considerations in Four-Corner Arthrodesis and Proximal Row Carpectomy: A Review

Total Wrist Arthroplasty for Posttraumatic Wrist Osteoarthritis: A Cohort Study Comparing Three Indications

SLAC Wrist: Midcarpal Fusion

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