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The outcome of scaphoid excision and four-corner arthrodesis for advanced carpal collapse at a minimum of ten years.
J Hand Surg Am. 2010 May; 35(5):719-25.JH

Abstract

PURPOSE

Scaphoid excision and 4-corner arthrodesis is a salvage option for patients with advanced carpal collapse. This study aims to compare the clinical outcomes of 4-corner arthrodesis (FCA) at one year, 2 years, and a minimum of 10 years.

METHODS

A cohort study was performed of patients having scaphoid excision and FCA procedure by a single surgeon. Thirty-one of 35 recruited were followed up for 10 years. The mean patient age was 47 years. All patients had scaphoid excision and FCA, using bone graft and 3M Shapiro staples (3M, St Paul, MN). Patients were followed up prospectively at one year, 2 years, and a minimum of 10 years after surgery by an independent observer. Three patients were lost to follow-up between the 2-year and 10-year assessments because they were untraceable, and one patient died at 7 years, without any further intervention. Before surgery, pain scores measured with a visual analog scale, range of wrist movement, grip and pinch strength, and scores from a self-assessment functional questionnaire were recorded prospectively. These measures were repeated at each time point, in addition to patient satisfaction scores measured on a visual analog scale.

RESULTS

The pain scores decreased from a median preoperative score of 6/10 to 0/10 at one year. Grip strength did not change significantly. Wrist flexion decreased significantly after surgery, by an average of 22%. The average patient-reported satisfaction score was 8/10. There was no significant change in pain, wrist function, satisfaction, or arc of motion between one and 10 years. Two of 35 patients recruited had gone on to a total wrist arthrodesis for ongoing pain.

CONCLUSIONS

The outcome of scaphoid excision and 4-corner arthrodesis is favorable at one year and does not deteriorate significantly between one and 10 years. There is a low rate of conversion to total wrist arthrodesis. Pain scores are reduced at the cost of reduced wrist flexion.

Authors+Show Affiliations

Modbury Public Hospital, Adelaide, Australia. greg@gregbain.com.auNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20381980

Citation

Bain, Gregory I., and Adam C. Watts. "The Outcome of Scaphoid Excision and Four-corner Arthrodesis for Advanced Carpal Collapse at a Minimum of Ten Years." The Journal of Hand Surgery, vol. 35, no. 5, 2010, pp. 719-25.
Bain GI, Watts AC. The outcome of scaphoid excision and four-corner arthrodesis for advanced carpal collapse at a minimum of ten years. J Hand Surg Am. 2010;35(5):719-25.
Bain, G. I., & Watts, A. C. (2010). The outcome of scaphoid excision and four-corner arthrodesis for advanced carpal collapse at a minimum of ten years. The Journal of Hand Surgery, 35(5), 719-25. https://doi.org/10.1016/j.jhsa.2010.01.025
Bain GI, Watts AC. The Outcome of Scaphoid Excision and Four-corner Arthrodesis for Advanced Carpal Collapse at a Minimum of Ten Years. J Hand Surg Am. 2010;35(5):719-25. PubMed PMID: 20381980.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The outcome of scaphoid excision and four-corner arthrodesis for advanced carpal collapse at a minimum of ten years. AU - Bain,Gregory I, AU - Watts,Adam C, Y1 - 2010/04/09/ PY - 2009/08/24/received PY - 2010/01/16/revised PY - 2010/01/26/accepted PY - 2010/4/13/entrez PY - 2010/4/13/pubmed PY - 2010/8/6/medline SP - 719 EP - 25 JF - The Journal of hand surgery JO - J Hand Surg Am VL - 35 IS - 5 N2 - PURPOSE: Scaphoid excision and 4-corner arthrodesis is a salvage option for patients with advanced carpal collapse. This study aims to compare the clinical outcomes of 4-corner arthrodesis (FCA) at one year, 2 years, and a minimum of 10 years. METHODS: A cohort study was performed of patients having scaphoid excision and FCA procedure by a single surgeon. Thirty-one of 35 recruited were followed up for 10 years. The mean patient age was 47 years. All patients had scaphoid excision and FCA, using bone graft and 3M Shapiro staples (3M, St Paul, MN). Patients were followed up prospectively at one year, 2 years, and a minimum of 10 years after surgery by an independent observer. Three patients were lost to follow-up between the 2-year and 10-year assessments because they were untraceable, and one patient died at 7 years, without any further intervention. Before surgery, pain scores measured with a visual analog scale, range of wrist movement, grip and pinch strength, and scores from a self-assessment functional questionnaire were recorded prospectively. These measures were repeated at each time point, in addition to patient satisfaction scores measured on a visual analog scale. RESULTS: The pain scores decreased from a median preoperative score of 6/10 to 0/10 at one year. Grip strength did not change significantly. Wrist flexion decreased significantly after surgery, by an average of 22%. The average patient-reported satisfaction score was 8/10. There was no significant change in pain, wrist function, satisfaction, or arc of motion between one and 10 years. Two of 35 patients recruited had gone on to a total wrist arthrodesis for ongoing pain. CONCLUSIONS: The outcome of scaphoid excision and 4-corner arthrodesis is favorable at one year and does not deteriorate significantly between one and 10 years. There is a low rate of conversion to total wrist arthrodesis. Pain scores are reduced at the cost of reduced wrist flexion. SN - 1531-6564 UR - https://www.unboundmedicine.com/medline/citation/20381980/The_outcome_of_scaphoid_excision_and_four_corner_arthrodesis_for_advanced_carpal_collapse_at_a_minimum_of_ten_years_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0363-5023(10)00117-6 DB - PRIME DP - Unbound Medicine ER -