High results and lower cost in four-bone arthrodesis with retrograde screws
Aim To describe the technique of the four-corner fusion with two retrograde crossed headless screws in cases of carpal collapse. Methods This technique is a consolidated procedure performed in cases of scaphoid non- union advanced collapse (SNAC) type II and III, scapholunate advanced collapse (...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Medical Association of Zenica-Doboj Canton
2022-02-01
|
| Series: | Medicinski Glasnik |
| Subjects: | |
| Online Access: | https://ljkzedo.ba/mgpdf/mg36/14_Ghargozloo_1450_A.pdf |
| Summary: | Aim To describe the technique of the four-corner fusion with two
retrograde crossed headless screws in cases of carpal collapse.
Methods This technique is a consolidated procedure performed
in cases of scaphoid non- union advanced collapse (SNAC) type
II and III, scapholunate advanced collapse (SLAC) type II and III
and in other cases of carpal collapse. Between 2017 and 2019 we
treated six male patients (a mean age of 55.0 years) with radiocarpal osteoarthritis. Our technique involves the use of two retrograde crossed headless screws; the first screw was placed distally
proximally from the uncinate to the lunate and the second screw
from the pyramidal to the capitate, crossed at approximately 90
degrees. Clinical and radiographic two-year follow-up was performed. Before the treatment and during the follow-ups VAS, PRWE
and DASH Quick score scales, measured wrist range of motion
(WROM) were administered and evaluated.
Results In all cases the X-ray consolidation of arthrodesis within
five months was noticed; in 50% patients already under 3-month
control. No observed signs of mobilization of screws and inflammatory or infectious processes were found. All patients were
satisfied (reduction/disappearance of pain). All surgically treated
patients resumed normal daily activities. These improvements
were confirmed by the results of the evaluation scale and clinical
examination.
Conclusion This technique, in our opinion, represents a gold standard. Its low costs of the material used (especially comparing to
other technique), a low prevalence of complications of materials
and fusion in 100% of cases should be also considered. |
|---|---|
| ISSN: | 1840-0132 1840-2445 |