Long-term outcomes of the four-corner fusion of the wrist:A systematic review  

作　　者：Octavian Andronic Ladislav Nagy Marco D Burkhard Fabio A Casari Daniel Karczewski Philipp Kriechling Andreas Schweizer Lukas Jud 

机构地区：[1]Department of Orthopaedics,Balgrist University Hospital,University of Zürich,Switzerland,Zürich 8008,Switzerland [2]Department of Trauma and Orthopaedics,CharitèUniversity Medicine Berlin,Center for Musculoskeletal Surgery,Berlin 10117,Germany

出　　处：《World Journal of Orthopedics》2022年第1期112-121,共10页世界骨科杂志（英文版）

摘　　要：BACKGROUND Four-corner fusion(4CF)is a motion sparing salvage procedure that is used to treat osteoarthritis secondary to advanced scapholunate collapse or longstanding scaphoid nonunion advanced collapse.Little is known about the long-term survivorship and outcomes of 4CF.AIM To report on clinical and functional long-term outcomes as well as conversion rates to total wrist fusion or arthroplasty.METHODS The systematic review protocol was registered in the international prospective register of systematic reviews(PROSPERO)and followed the PRISMA guidelines.Original articles were screened using four different databases.Studies with a minimum Level IV of evidence that reported on long-term outcome after 4CF with a minimum follow-up of 5 years were included.Quality assessment was performed using the Methodological Index for Non-Randomized Studies criteria.RESULTS A total of 11 studies including 436 wrists with a mean follow-up of 11±4 years(range:6-18 years)was included.Quality assessment according to Methodological Index for Non-Randomized Studies criteria tool averaged 69%±11%(range:50%-87%).Fusion rate could be extracted from 9/11 studies and averaged 91%.Patient-reported outcomes were extracted at last follow-up from 8 studies with an average visual analog scale of 1±1(range:0-2)and across 9 studies with an average Disabilities of the Arm,Shoulder and Hand score of 21±8(range:8-37).At last follow-up,the cumulative conversion rate to total wrist fusion averaged 6%.There were no conversions to total wrist arthroplasty.CONCLUSION The 4CF of the wrist is a reliable surgical technique,capable of achieving a good long-term patient satisfaction and survivorship with low rates of conversion to total wrist fusion.

关 键 词：Four-corner fusion Partial wrist arthrodesis Midcarpal arthrodesis Scapholunate collapse wrist Scaphoid nonunion advanced collapse Scaphoid nonunion 

分 类 号：R684.3[医药卫生—骨科学]