four-corner fusion
Salvage wrist procedure fusing capitate, hamate, lunate, and triquetrum while removing scaphoid for advanced arthritis.
Full Definition
Four-corner fusion is a salvage procedure for advanced wrist arthritis involving arthrodesis of the capitate, hamate, lunate, and triquetrum bones with concurrent scaphoid excision. This procedure is commonly indicated for scapholunate advanced collapse (SLAC) arthritis or scaphoid nonunion advanced collapse (SNAC) arthritis where the radiocarpal joint remains relatively preserved. The goal is to eliminate painful motion at the midcarpal joint while maintaining some wrist flexion and extension. The procedure involves removing arthritic cartilage from the four bones, positioning them in proper alignment, and achieving fusion using bone graft and internal fixation such as plates, screws, or headless compression screws. Postoperative immobilization is required until fusion is achieved, typically 8-12 weeks. The procedure generally provides good pain relief with some loss of wrist motion compared to normal.
Usage
Usage note: Specify fixation method and graft material used; distinguish from other limited wrist arthrodesis procedures.
In Context
- "Four-corner fusion was performed with headless compression screws and corticocancellous bone graft." — Operative report
- "The patient achieved solid four-corner fusion with significant improvement in wrist pain at six months." — Follow-up note