4 Corner Fusion
Problem.
- Osteoarthritis in the wrist joint between the radius and the scaphoid
- Pain and Stiffness is felt in the wrist.
Cause
- Usually results following a scaphoid injury that hasn’t healed properly or scapho-lunate ligament injury.
Diagnosis
- X-rays will usually confirm the diagnosis.
- A CT or MRI may be required to look at the joint surfaces of the other carpal bones.
Treatment
- Operation – Day stay or overnight stay.
- General anaesthetic with arm block.
- Removal of the arthritic scaphoid bone.
- Fusion of the remaining carpal bones with either staples or spider plate and local bone graft.
- Occasionally bone graft from the hip is required.
Potential Complications
- Infection, Haematoma, stiffness.
- Delayed or non union of carpal bones.
- CRPS (exaggerated pain response from the nerves).
Post-Operative Care
- Analgesia, Elevation in sling
- Back slab for 2 weeks then either cast or splint for four to six weeks till carpus unites
