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Current Trends in 4-Corner and 3-Corner Fusions: Comparing Open and Arthroscopic Approaches
1Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, Toronto Western Hospital, University Health Network, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Orthopaedic Surgery, Department of Surgery, Toronto Western Hospital, University Health Network, Temerty Faculty of Medcine, University of Toronto, Toronto, Ontario, Canada.
Four-corner and three-corner fusions treat wrist arthritis, offering pain relief and mobility. Arthroscopic techniques may reduce complications and speed recovery compared to open surgery for these wrist fusions.
Area of Science:
- Orthopedic Surgery
- Hand and Wrist Surgery
- Arthroscopy
Background:
- Four-corner (4C) and three-corner (3C) fusions are standard surgical treatments for scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) wrist arthritis.
- These procedures aim to reduce pain and preserve some wrist function.
Purpose of the Study:
- To review the established treatments for SLAC and SNAC wrist arthritis.
- To explore the potential benefits of arthroscopic techniques compared to traditional open surgery.
- To discuss various fixation methods and their impact on outcomes.
Main Methods:
- Review of current literature on 4C and 3C fusions for wrist arthritis.
- Comparison of open versus arthroscopic surgical approaches.
- Analysis of different fixation techniques (screws, plates, staples, wires).
Main Results:
- Both open and arthroscopic 4C/3C fusions alleviate pain and maintain partial wrist mobility.
- Arthroscopic approaches may offer advantages in reduced complications and faster recovery.
- Fixation method choice impacts surgical stability and patient outcomes.
Conclusions:
- Arthroscopic 4C/3C fusions show promise for wrist arthritis treatment, potentially preserving motion and grip strength.
- Long-term comparative data between open and arthroscopic methods are still limited.
- Treatment selection requires individualized consideration of patient factors, surgeon skill, and anatomy.
