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Four-corner arthrodesis using two headless compression screws.

S D Iordache, D Nam, J Paylan

Acta Orthopaedica Belgica

|September 30, 2016

Summary

This summary is machine-generated.

Four-corner wrist arthrodesis achieved fusion in 24 of 27 patients. However, radiographs at three months post-surgery are unreliable for confirming bony fusion due to poor inter-observer agreement.

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Area of Science:

Orthopedic surgery
Musculoskeletal research
Radiographic imaging analysis

Background:

Four-corner wrist arthrodesis is a surgical procedure for wrist fusion.
Headless compression screws are utilized for fixation in this procedure.
Assessing fusion reliably is crucial for patient outcomes.

Purpose of the Study:

To evaluate the outcomes of four-corner wrist arthrodesis using two headless compression screws.
To assess the reliability of radiographic assessment for bony fusion at three months postoperatively.

Main Methods:

Retrospective review of 27 patients undergoing four-corner wrist arthrodesis between 1998 and 2007.
Collection of demographic data, diagnoses, range of motion, pain, and complications.
Radiographic analysis of 77 X-ray series by three independent interpreters to determine bony fusion.

Main Results:

Fusion was achieved in 24 out of 27 wrists (89% success rate).
Overall inter-observer agreement for radiographic fusion was fair (κ=0.41).
Inter-observer agreement was poor (κ=0.07) when assessing fusion at the critical postoperative timing (86 days).

Conclusions:

Four-corner wrist arthrodesis with two headless compression screws demonstrates fusion rates consistent with literature.
Radiographs obtained at three months post-four-corner arthrodesis are unreliable for diagnosing bony fusion.
Further investigation into optimal timing and methods for assessing wrist fusion is warranted.