TechniquesFour-Corner Fusion and Scaphoid Excision Using Headless Compression Screws for SLAC and SNAC Wrist DeformitiesRichards, Allison Alexander MD; Afifi, Ahmed M. MD; Moneim, Moheb S. MDAuthor Information Department of Orthopaedics and Rehabilitation, Division of Hand Surgery, University of New Mexico Health Sciences Center, Albuquerque, NM No extramural funding was received for this project. Allison Alexander Richards, MD, Hand Fellow, 2007-2008, is currently at the ABQ Health Partners Hand Clinic, Albuquerque, NM. Ahmed M. Afifi, MD, Hand Fellow, 2007 to 2008, is currently at the Cleveland Clinic, Cleveland, OH. Address correspondence and reprint requests to Moheb S. Moneim, MD, Department of Orthopaedics and Rehabilitation, Division of Hand Surgery, MSC10 5600, 1 University of New Mexico, Albuquerque, NM 87131. E-mail: [email protected]. Techniques in Hand & Upper Extremity Surgery: June 2011 - Volume 15 - Issue 2 - p 99-103 doi: 10.1097/BTH.0b013e3181f60fec Buy Metrics Abstract Scapholunate advanced collapse and scaphoid nonunion advanced collapse wrist deformities are the most common causes of traumatic arthritis of the wrist. Four-corner fusion and scaphoid excision has proven to be an effective procedure for relieving pain and preserving range of motion in the wrist joint. Several methods for providing fixation of the midcarpal joint during fusion have been used, including K-wires, staples, and the Spider plate. K-wire fixation has proven effective, but requires a period of cast immobilization to protect the fusion mass. The Spider plate was promising, but has not been without complications. The development and improvements in cannulated headless compression screws has resulted in increased indications for their use, including fixation for 4-corner fusion. We review the technique and tips developed by the senior author over the last several years using headless compression screws for fixation of the midcarpal joint. Acutrak 2 Standard implants were used. This technique has allowed for early range of motion with reliable fusion rates. © 2011 Lippincott Williams & Wilkins, Inc.