Management of the Scaphoid during Four-Corner Fusion - A Cadaveric Study

Paul E. Kobza, Jeffrey E. Budoff, Ming-Long Yeh, Zong Ping Luo

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)


Purpose: To examine the effects of scaphoid retention, inclusion, and excision on wrist motion and radiolunate contact characteristics in a cadaveric model after simulated 4-corner fusion with rigid internal fixation. Methods: Seven fresh-frozen cadaveric upper extremities were examined. For all surgical manipulations the motion was measured and contact characteristics were assessed using ultra-low prescale pressure-sensitive film. Results: Compared with the intact specimen, simple 4-corner fusion with scaphoid retention led to a significant decrease in extension, radial deviation, and ulnar deviation, but no change in radiolunate contact characteristics. After 4-corner fusion there was no significant difference in motion or radiolunate contact characteristics between scaphoid retention and scaphoid inclusion. After 4-corner fusion scaphoid excision allowed significantly greater radial deviation compared with scaphoid retention and scaphoid inclusion. Compared with the intact specimen 4-corner fusion with scaphoid excision also led to a significant increase in radiolunate contact area and mean contact pressure. Conclusions: When performing 4-corner arthrodesis in the absence of radioscaphoid arthritis, scaphoid excision may improve motion at the cost of increased mean radiolunate contact pressure.

Original languageEnglish
Pages (from-to)904-909
Number of pages6
JournalJournal of Hand Surgery
Issue number6
Publication statusPublished - 2003 Jan 1

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine


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