Association of Kirschner wires and shape-memory staple in four-corner arthrodesis

ABSTRACT

Background. Wrist arthrosis is a painful disease that is responsible for a reduced wrist function and upper limb dysfunction. Proposed by Watson in 1984, scaphoidectomy and four-corner arthrodesis has good results in scapho-lunate advanced collapse (SLAC) and scaphoid non-union advanced collapse (SNAC) treatment.

Objectives. The purpose of this study was to analyze the results of four-corner arthrodesis using Kirschner wire and shape-memory staples.  

Methods. 12 patients (12 wrists) were operated by scaphoidectomy and four-corner arthrodesis according to Watson technique, using Kirschner wires fixation for capito-luno-hamato fusion and shape-memory staples for hamato-triquetral fusion. The mean age of the patients was 64.7 years, and the period of follow-up was 2.1 years.

Results. The results were evaluated using preoperative data, surgery protocols and clinical postoperative data obtained at follow-up: pain, patient’s satisfaction, force, range of motion, X-ray imaging. The fusion was achieved in all cases in a mean time of 2.4 months for all involved articulations. The mean postoperative range of motion was 26.25⁰ of extension, 24.16⁰ of flexion, 16.11⁰ of radial inclination and 18.89⁰ of cubital inclination. After surgery, compared to the unaffected contralateral side, grip strength was 62.8%.

Conclusions. Combination of K-wires and shape-memory staple for four-corner arthrodesis is very efficient in treating SLAC and SNAC lesions.

Keywords: four-corner arthrodesis, K-wires, shape-memory staple.

Address of correspondence:
Florin GROSEANU
University of Medicine and Pharmacy Carol Davila Bucharest, St. Pantelimon Emergency Hospital, Romania
Address: Sos. Pantelimon No 340, Sector 2, Bucharest, Romania
Email: drgroseanuflorin@yahoo.com