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Biomechanical comparison of three fixation techniques used for four-corner arthrodesis
J Kraisarin1, D G Dennison, L J Berglund
1Biomechanics Laboratory, Division of Orthopedic Research, Mayo Clinic College of Medicine, Rochester, USA.
The Journal of Hand Surgery, European Volume
|June 4, 2011
Summary
The locked dorsal circular plate offers superior stability for four-corner arthrodesis compared to other fixation methods. This biomechanical study highlights its potential to reduce nonunion risks in wrist fusion surgery.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Hand and Wrist Surgery
Background:
- Clinical outcomes of four-corner arthrodesis for wrist instability are variable.
- Nonunion rates may be influenced by the chosen fixation technique.
Purpose of the Study:
- To compare the biomechanical stability of three fixation methods for four-corner arthrodesis.
- To evaluate lunocapitate displacement under cyclic loading with different implants.
Main Methods:
- Simulated four-corner arthrodesis was performed on cadaver wrists.
- Cyclic loading was applied to Kirschner wire, dorsal circular plate, and locked dorsal circular plate constructs.
- Testing continued until implant failure or 1 mm lunocapitate displacement.
Main Results:
- The locked dorsal circular plate demonstrated significantly greater stability.
- This construct showed significantly less displacement compared to dorsal circular plates (p=0.018) and K-wires (p=0.006).
Conclusions:
- Locked dorsal circular plates provide superior biomechanical stability in simulated four-corner arthrodesis.
- These findings suggest a potential benefit for locked plates in reducing nonunion rates, though further clinical validation is needed.