Shindle M K, Burton K J, Weiland A J, Domb B G, Wolfe S W
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA.
J Hand Surg Eur Vol. 2007 Feb;32(1):50-3. doi: 10.1016/j.jhsb.2006.08.016. Epub 2006 Oct 17.
Four corner arthrodesis is an accepted salvage operation for scapholunate advanced collapse and scaphoid non-union advanced collapse. Circular plates were introduced in 1999 and promoted as a rapid and more stable method for this procedure. A retrospective chart review was performed on all patients who were treated with the Spider Limited Wrist Fusion Plate (Kinetikos Medical Inc., San Diego, CA). Sixteen patients were identified and followed clinically and with X-rays for an average of 16 (range 5-38) months. Nine out of the 16 patients (56%) had complications, including non-union (25%), delayed union (6%), dorsal impingement (25%), radial styloid impingement (6%) and broken screws (13%). The purpose of this study was to compare our complication rate using circular plates with published outcomes using traditional methods of fixation: this study identified a significantly higher complication rate and lower union rate using circular plate fixation for four-corner arthrodesis compared with previously published techniques.
四角融合术是舟月骨晚期塌陷和舟骨不愈合晚期塌陷公认的挽救手术。环形钢板于1999年引入，并被推广为该手术的一种快速且更稳定的方法。对所有接受Spider有限腕关节融合钢板（Kinetikos Medical Inc.，圣地亚哥，加利福尼亚州）治疗的患者进行了回顾性病历审查。确定了16例患者，并进行了平均16个月（范围5 - 38个月）的临床和X线随访。16例患者中有9例（56%）出现并发症，包括不愈合（25%）、延迟愈合（6%）、背侧撞击（25%）、桡骨茎突撞击（6%）和螺钉断裂（13%）。本研究的目的是将我们使用环形钢板的并发症发生率与使用传统固定方法公布的结果进行比较：本研究发现，与先前公布的技术相比，使用环形钢板固定进行四角融合术的并发症发生率显著更高，愈合率更低。
