Four corner fusion using a multidirectional angular stable locking plate

Table 1 Patient and surgery characteristics, time to union and follow up

Number	Age	Sex	Hand	Classification	Lunate type	VISI/DISI	Associatedsurgery	No. of screws	Union (mo)	Complications	Follow up(mo)
1a	64	M	L	SLAC	1		PIN	11	4		30
1b	65	M	R	SLAC	1		PIN	11	6		24
2	52	F	R	SLAC	2	V	PIN	12	3		10
3	40	M	L	SLAC	1	D	Distal radius graft (previous PIN)	12	9		11
4	38	M	L	SNAC	1	D	PIN + styloidectomy	11	16	Screws Penetrating CMC joint	35
5	72	F	L	SNAC	1	D	PIN + Iliac BG	8	3		8
6	55	M	L	SNAC	2	D	PIN + distal radius graft	11	2		18
7	61	M	R	SNAC	2	D	PIN + distal radius graft	11	3		10
8	33	M	L	Lunate fracture	1	V	PIN	12	171	Non-union, revised	23
9	35	M	L	SNAC	2		PIN	11	7	Hypertrophic bone	16
10	50	M	R	SNAC	2		PIN	10	6	Scar sensitivity	25
11	55	M	L	SNAC	1		PIN	10	4		26
12	46	M	L	SNAC	2	D	PIN	12	7		25
13	48	F	L	SNAC	1	D	PIN	12	5		25
14	40	M	R	SNAC	2		PIN	12	8	Skin necrosis over plate + flap coverage	24
15	18	M	R	Scaphoid	2		PIN, plate removal distal radius graft	10	9		16
16	50	M	R	SLAC	1		PIN	12	271	Non-union, revised	27

¹Indicatates total time to final union including both index procedure and revision surgery. PIN: Posterior interosseous neurectomy; M: Male; F: Female; L: Left; R: Right; SLAC: Scapholunate advanced collapse; SNAC: Scaphoid nonunion advanced collapse; V: VISI; D: DISI; BG: Bone graft; CMC: Carpometacarpal.

Table 2 Outcomes at discharge or at latest follow up

Number	JAMAR (kg) (unaffected)	% grip strength difference	Flexion (unaffected)	Extension (unaffected)	DASH	Return to work	Satisfied?
1a	22	NA	30	20	43	Retired	Yes
1b	24	NA	25	40	43	Retired	Yes
2	11 (26)	42%	25 (50)	15 (40)	48	Office	Yes
3	30 (36)	83%	45	45	15	Office	Yes
4	32 (37)	87%	35 (92)	18 (80)	48	Heavy manual	Yes
5	4 (18)	22%	30	10	35	Retired	Yes
6	48 (32)	150%	30	45	20	Office	Yes
7	25 (38)	66%	45	45	13	Retired	Yes
8	22 (55)	40%	30	20	61	No	No
9	36 (48)	75%	20	10	43	No	Yes
10	30 (40)	75%	30	60	20	Office	Yes
11	18 (52)	35%	20	20	35	Office	Yes
12	26 (35)	74%	40	40	15	Yes	Yes
13	25 (30)	83%	20	50	13	Manual	Yes
14	45 (35)	129%	30	40	42	No	No
15	20 (38)	53%	20	35	15	Office	Yes
16	40 (55)	73%	30	15	27	Office	Yes

Data for the unaffected wrist where available are given in brackets. DASH: Disabilities of the arm, shoulder and hand.