Four-corner arthrodesis for the treatment of scapholunate advanced collapse (SLAC) wrist

Objective To introduce a new procedure for severely painful wrist with scapholunate advanced collapse (SLAC). Methods Eleven cases of stage Ⅲ SLAC wrist with severe wrist pain,decreased grip strength,and loss of range of motion (ROM) were involved in the study. Four corner arthrodesis, which was also called SLAC wrist reconstruction, consisted of a limited wrist arthrodesis incorporating capitate, lunate, hamate and triquetrum. Results The follow up ranged from seven months to three and a half years. The results were excellent in 7 cases, good in 2 cases, fair in 1 case and poor in 1 case. With the exception of 1 case, no pain or almost painless result was obtained in 10 patients. The grip strength and ROM averaged 80% and 51% of opposite wrist, respectively. Conclusion Four corner arthrodesis is a reliable salvage procedure for painful SLAC wrist of stage Ⅲ , which could make a painless wrist with useful grip strength and preservation of wrist motion.