Article

We assessed the effect of four-corner intercarpal fusion with locking plate
without bone graft on daily activities and pain in patients with stage II and III
scapholunate advanced collapse and scaphoid nonunion.
Twenty-one patients who
underwent four-corner fusion with scaphoidectomy without bone graft were
evaluated with the Disabilities of the Arm, Shoulder and Hand (QuickDASH) and
Visual Analog Scale (VAS) pain scores before and 16 months after surgery. We also
compared postoperative grip strength between the operated and the healthy side. A
principal component analysis was used to establish the relationship between
functional benefit, immobilization period and number of physiotherapy sessions.
We compared our results with published data. VAS and QuickDASH scores improved
significantly. Loss of strength was observed postoperatively. QuickDASH score
improved the most with a short immobilization period. No significant difference
was found relative to the literature for follow-up time, range of motion, grip
strength and QuickDASH score. All patients had bone fusion after 1 year.
Four-corner fusion with locking plate is a procedure that reduces pain and
improves functional scores.
Our results are equal to those reported in the
literature with bone graft. The union rate seemed high despite the absence of
bone graft but was only assessed by x rays. This study allowed us to establish a
treatment guideline: a shorter immobilization leads to better recovery.
CI - Copyright (c) 2017. Published by Elsevier Masson SAS.

Langue : ANGLAIS