Decreased Complication Rate Using Partially Threaded Compared With Fully Threaded Compression Screws in 4 Corner...

Area of Science:

• Orthopedic Surgery
• Hand and Wrist Surgery
• Arthritis Treatment

Background:

• Scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) are common wrist arthritis types.
• Four corner arthrodesis is a surgical option for these conditions.

Purpose of the Study:

• To compare the union rate and complication profile of 4 corner arthrodesis using partially threaded versus fully threaded headless compression screws.
• To evaluate the efficacy of different screw types in treating SLAC and SNAC wrist arthritis.

Main Methods:

• Retrospective review of 35 wrists in 33 patients undergoing 4 corner fusion with headless compression screws (2016-2021).
• Comparison of union rates and complication profiles between partially threaded and fully threaded screw groups.
• Analysis of demographics, comorbidities, and radiographic outcomes.

Main Results:

• 100% union rate with partially threaded screws vs. 84.2% with fully threaded screws.
• Significantly lower complication rate with partially threaded screws (6.3%) compared to fully threaded screws (52.6%, P = .004).
• Complications included avascular necrosis of the lunate and screw loosening.

Conclusions:

• Four corner arthrodesis with antegrade compression screws is an effective wrist fusion method.
• Partially threaded screws are associated with fewer complications than fully threaded screws in this procedure.
• Further research with larger cohorts is recommended to confirm these findings.