Observational Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Aug 18, 2016; 7(8): 501-506
Published online Aug 18, 2016. doi: 10.5312/wjo.v7.i8.501
Four corner fusion using a multidirectional angular stable locking plate
Tahseen Chaudhry, Michelle Spiteri, Dominic Power, Mark Brewster
Tahseen Chaudhry, Michelle Spiteri, Dominic Power, Mark Brewster, Department of Hand Surgery, Queen Elizabeth Hospital, Birmingham B15 2TH, United Kingdom
Author contributions: Chaudhry T contributed to design and planning, protocol, data collection and processing, literature review, paper write up and revisions; Spiteri M contributed to data collection and processing, literature review; Power D contributed to study design and setup, data collection, paper review; Brewster M contributed to design and planning, protocol, data collection and processing, literature review.
Institutional review board statement: The study met the requirements of our hospital Institutional Review Board for clinical research. None of the authors have any conflict of interest to declare.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: None of the individual authors of this paper have any conflicts of interest.
Data sharing statement: No additional data are available for this study. All data are included in the paper itself.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Tahseen Chaudhry, Department of Hand Surgery, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, United Kingdom. tahseen_c@hotmail.com
Telephone: +44-1217-775956 Fax: +44-1213-712000
Received: January 31, 2016
Peer-review started: February 1, 2016
First decision: March 24, 2016
Revised: May 11, 2016
Accepted: June 1, 2016
Article in press: June 3, 2016
Published online: August 18, 2016

AIM: To review the results of our experience with the Medartis Aptus plating system for four corner arthrodesis of the wrist, which uses a combination of compression screws and variable angle locking screws.

METHODS: We reviewed the results of 17 procedures in 16 patients that underwent scaphoid excision and four corner fusion using the Medartis Aptus system between May 2010 and June 2014. The primary outcome measure was radiographic and clinical union.

RESULTS: The mean clinical follow up time was 20.6 mo. The mean union time was 6 mo. Two non-unions required revision procedures. The mean disabilities of the arm, shoulder and hand score taken after union was 36. The mean final grip strength was 27 kg. The mean final range of movement was 30° flexion and 31° of extension. All patients had a restored scapholunate angle on postoperative radiographs. There were no incidences of dorsal impingement.

CONCLUSION: Overall our experience with the Aptus plating system shows comparable results to other methods of fixation for four corner fusion, in the short to medium term.

Keywords: Wrist surgery, Arthrodesis, Locking plate, Scaphoidectomy, Partial fusion

Core tip: This paper demonstrates that a multi angle locking plate is a suitable device for four corner fusion. It demonstrates that results are comparable to those of other means of fusion in the short to medium term.