Bone grafting in four-corner mid-carpal fusion

Area of Science:

• Orthopedic Surgery
• Hand and Wrist Surgery
• Bone Grafting Techniques

Background:

• Scaphoid Nonunion Advanced Collapse (SNAC) and Scapholunate Advanced Collapse (SLAC) wrist are common degenerative conditions.
• Four-corner fusion is a recognized surgical procedure for treating advanced SNAC and SLAC wrist.
• Standard fusion techniques may benefit from adjunct bone grafting for improved outcomes.

Purpose of the Study:

• To describe a novel bone grafting technique for four-corner fusion.
• To illustrate a method for facilitating autograft placement in wrist fusion surgery.
• To enhance bone-to-bone contact in the fusion mass.

Main Methods:

• A step-by-step, illustrated surgical technique is presented.
• The technique focuses on the preparation and placement of an autograft.
• The graft is designed for maximal contact with all articulating surfaces involved in the fusion.

Main Results:

• The described technique allows for straightforward autograft insertion.
• The bone graft ensures comprehensive contact with all bone surfaces within the fusion site.
• This method is compatible with existing four-corner fusion procedures.

Conclusions:

• The illustrated bone grafting technique offers a practical adjunct to four-corner fusion for SNAC and SLAC wrist.
• This approach may improve the reliability and success rate of wrist fusion.
• Enhanced graft incorporation and bone apposition are anticipated benefits.