Systematic Reviews
Copyright ©The Author(s) 2022.
World J Orthop. Jan 18, 2022; 13(1): 112-121
Published online Jan 18, 2022. doi: 10.5312/wjo.v13.i1.112
Table 1 Criteria for study selection
Inclusion criteria
Exclusion criteria
Human studies in English or German languageOral presentations, cadaveric or review articles, animal studies
Minimum Level IV case series studies using Oxford Centre for Evidence-Based Medicine 2011 Levels of EvidenceLanguage not in English or German
Four corner fusion surgery using any techniqueMinimum follow-up less than 5 yr
A minimum follow-up of 5 yrInflammatory arthropathy as etiology
Clinical and radiographic data including patient-reported outcomes, grip/pinch strength, range of motion, fusion rates, revisions or complications have been reportedInsufficient outcome data reported
Table 2 Demographics, surgical techniques and patient-reported outcomes
AuthorYearStudy designNumber of wristsIndicationMean age (yr)Fixation TechniqueVAS
Cha SM 2013Retrospective case series40SLAC47K-wires6.32.0441775
Luegmair M 2012Retrospective case series24SLAC, SNAC, SCAC53Plates---1975
Bain GI 2010Prospective cohort study31SLAC47Staples6.01.0--87
Berkhout MJL 2015Retrospective cohort study8SLAC, SNAC45K-wires-0.3--62
Kitzinger HB2003Retrospective case series37SLAC, SNAC46K-wires2.71.7-2462
Trail I2015Retrospective case series116SLAC, SNAC47K-wires, Plates, Staples, Screws-1.9-3762
Neubrech F2012Retrospective case series60SLAC, SNAC, unclassified OA63K-Wires-1.4-2087
Odella S2018Retrospective case series20SLAC, SNAC53Plates-2.0-1762
Traverso P2017Retrospective case series15SLAC, SNAC49K-wires---862
Wagner ER2017Retrospective cohort study51Unclassified OA34Plates---1975
Williams J2018Retrospective cohort study61SLAC, SNAC, perilunate OA52K-wires, Plates, Screws-1.0-2750
SD± 7± 0.6± 8± 11
Table 3 Fusion rates, survivorship including rates of conversion to total wrist fusion and complications
Number of wrists
Fixation technique
Nonunion (n)
Fusion (%)
Revisions (%)
Conversion to TWF (%)
Cha SM 40K-wires01002 (5)1 (3)1 x impingement
Luegmair M 24Plates2922 (8)0-
Bain GI 31Staples3905 (16)2 (7)1 x delayed union
Berkhout MJL 8K-wires188--1 x CRPS, 1 x delayed union
Kitzinger HB 37K-wires-----
Trail I 116K-wires, plates, staples, screws287614 (12)6 (5)3 x impingement
Neubrech F 60K-wires-----
Odella S 20Plates01001 (5)01 x implant loosening
Traverso P 15K-wires01002 (13)1 (7)-
Wagner ER 51Plates68815 (29)6 (12)1 x infection, 8 x impingement
Williams J 61K-wires, plates, screws39521 (34)12 (20)4 x impingement, 1 x ulnar impaction, 1 x infection
Totals/Averages46343 (9%)91 ± 762 (13%)28 (6%)
Table 4 Range of motion and grip strength
Grip strength (%)
ROM Flexion-extension
ROM radial-ulnar (%)
Cha SM 718584664539
Luegmair M 387057642430
Bain GI 273078573530
Berkhout MJL ---87-49
Kitzinger HB 698068623534
Trail I -53-60-26
Neubrech F -85-63-30
Odella S -75-79--
Traverso P ---69-33
Wagner ER 6065-54-32
Williams J ------
SD± 17± 18± 10± 10± 8± 6