Summary
Four-corner arthrodesis is an accepted surgical option for treatment of scapholunate
advanced collapse, scaphoid non-union advanced collapse and midcarpal instability.
A preferred source of bone graft for performing four-corner arthrodesis is the iliac
crest. An alternative and more convenient donor site is the distal radius. The aim
of this study was to investigate whether the union rate after four-corner arthrodesis
is influenced by the source of bone graft, that is, iliac crest or distal radius.
In a retrospective analysis, charts and radiographs of 180 patients were identified.
In 109 patients, iliac crest bone grafts were used, whereas 71 patients received distal
radius bone grafts. In the iliac crest bone graft group, 101 out of 109 patients obtained
a solid radiographic union of the arthrodesis at an average of 10 weeks after surgery,
and non-union in eight patients (7.3%). In the distal radius bone graft group, X-rays
of 66 patients showed bone union after an average of 10 weeks after surgery as well
and five patients with non-union (7.0%) respectively. There was no statistical difference
in bone union. Our data show that distal radius bone graft compares equally to iliac
crest bone graft in performing four-corner arthrodesis. The advantages of the distal
radius bone graft include a minor surgical exposure and the avoidance of using a distant
anatomic site with associated donor-site morbidity.
Keywords
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Article info
Publication history
Published online: October 20, 2011
Accepted:
September 27,
2011
Received:
May 21,
2011
Identification
Copyright
© 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
