Four Corner Intercarpal Arthrodesis

Intercarpal arthrodesis is a common motion sparring procedure for post-traumatic arthritis of the wrist. Untreated scaphoid non-union or scapholunate ligament injury often leads to progressive arthritis of the wrist that can be salvaged by proximal row carpectomy (PRC), limited intercarpal arthrodesis or total wrist fusion. Most surgeons elect to perform a motion sparring procedure in lieu of total wrist fusion. PRC is favored by many because of the ease of surgery and no need to obtain bony union. However, several reports are pessimistic about the out comes of the PRC operation in the long term. Most agree that the four corner arthrodesis with scaphoid excision is the optimal reconstruction to maintain wrist motion and strength and provide long-term durability.

An Anatomical Database of Carpal Bone Measurements for Intercarpal Arthrodesis

During limited intercarpal fusion it is sometimes difficult to determine correct screw length and staple size. This is because of overlap, and the shape and orientation of the carpal bones on radiography. One hundred complete sets of dry cadaver carpal bones were measured to provide an anatomical database of carpal bone measurements. This should help prevent inadvertent overpenetration of fixation devices during surgery.