Can Four Corner Fusion in Scaphoid Non-union Advanced Collapse (SNAC) Preserve Functional Range of Motion?

Abstract

Background: A scaphoid fracture is one the most disabling fractures in the wrist joint when a fractured scaphoid is neglected or improperly treated leading to Scaphoid Non-union Advanced Collapse (SNAC) wrist deformity with 5 stages. This study aimed to evaluate the clinical and radiological results of a simple technique of K wires fixation in the limited fusion of wrist in four corner fusion for surgical management of scaphoid nonunion advanced collapse with partial wrist denervation. Methods: This retrospective clinical study included 14 patients, who were heavy manual workers and farmers suffered from neglected fracture scaphoid at least 2 years before surgery and were treated conservatively except two patients. Results: Eleven patients got good results, 2 patients got fair results, and 1 patient got poor results. All patients had radiological signs of solid fusion at the end of the follow-up time with the mean duration of time to get complete fusion 6-12 weeks. After surgery, one patient got a superficial infection in the wound, one patient suffered from dorsal impingement between radius bone and capitate. Conclusion: The results of this study showed that the patient's degree of satisfaction is high, so the surgery provides good to exceptional wrist pain relief..