Management of the scaphoid during four-corner fusion-a cadaveric study.
نویسندگان
چکیده
PURPOSE To examine the effects of scaphoid retention, inclusion, and excision on wrist motion and radiolunate contact characteristics in a cadaveric model after simulated 4-corner fusion with rigid internal fixation. METHODS Seven fresh-frozen cadaveric upper extremities were examined. For all surgical manipulations the motion was measured and contact characteristics were assessed using ultra-low prescale pressure-sensitive film. RESULTS Compared with the intact specimen, simple 4-corner fusion with scaphoid retention led to a significant decrease in extension, radial deviation, and ulnar deviation, but no change in radiolunate contact characteristics. After 4-corner fusion there was no significant difference in motion or radiolunate contact characteristics between scaphoid retention and scaphoid inclusion. After 4-corner fusion scaphoid excision allowed significantly greater radial deviation compared with scaphoid retention and scaphoid inclusion. Compared with the intact specimen 4-corner fusion with scaphoid excision also led to a significant increase in radiolunate contact area and mean contact pressure. CONCLUSIONS When performing 4-corner arthrodesis in the absence of radioscaphoid arthritis, scaphoid excision may improve motion at the cost of increased mean radiolunate contact pressure.
منابع مشابه
Scaphoid excision with four-corner fusion: a biomechanical study.
PURPOSE Partial wrist arthrodesis is a commonly performed procedure for the treatment of posttraumatic wrist arthritis because of its ability to provide pain relief without sacrificing complete wrist motion. The purpose of this study was to evaluate the redistribution of force after four-corner fusion and scaphoid excision, and to correlate the findings with the reported clinical outcomes. ME...
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OBJECTIVE To compare the functional results of carpectomy and four-corner fusion surgical procedures for treating osteoarthrosis following carpal trauma. METHODS In this prospective randomized study, 20 patients underwent proximal row carpectomy or four-corner fusion to treat wrist arthritis and their functional results were compared. The midcarpal joint was free of lesions in all patients. ...
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Although nearly every combination of intercarpal arthrodeses has been described, excision of the scaphoid and fusion of the remaining carpal bones in neutral alignment was a unique concept when it was introduced nearly 20 years ago. This time-tested and established procedure that is commonly known as the 4-corner or 4-bone arthrodesis is based on the principle that the radiolunate articulation ...
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ورودعنوان ژورنال:
- The Journal of hand surgery
دوره 28 6 شماره
صفحات -
تاریخ انتشار 2003