four-corner fusion of the wrist (avascular necrosis of the scaphoid)

[lerrymoe]

Hello, I have developed somehow an avascular necrosis of the scaphoid. The condition happens when the the scaphoid is broken and one of the parts is not supplied with blood and dies. The only good news is that it was not on my right hand, since I'm right handed. The doc wants now to do a partial fusion of the wrist, with excision of the scaphoid and fusing the other 4 bones on the top of the wrist to provide stability. The excision of the scaphoid is said to be the only solution with partial fution of the wrist since I have alredy developed arthritis on the concerned wrist.  

My current situation is the following: almost no extention or flexion on the wrist; all other movements intact. If I keep the hand continuously in a splint i'll have no pain, but if i take it out i'll have pain in a very short time, doing even minor tasks.

Since I am quite young (29yrs) I am wondering what should I do. I dont want to live in pain, but I also know that this surgery will probably not be the end of this story. I know about this since the beginning of the year, and since then I've also done almost no sports. Before that I did sports almost every day.

My question is: has anyone here experience with partial fusion of the wrist? (four-corner fusion). Would you recommend it? What was the outcome?

Thanks a lot in advance,

Lerry  

[gregggy]

For anyone considering it, I am 21 and have had the four corner bone fusion. The post surgery pain for me was not bad at all, the arthritis initially caused more pain. Although with the limited mobility, the surgery is a good relief for pain. However, I had more than just the scaphoid taken out so down the road, my doctor expects 10 years, I will need a full wrist fusion to get rid of all the mobility. So be aware with a four corner bone fusion, you may be like me and ware out the only metacarpals intact.  

[santij]

Glad found this forum and has great information.

Same story like many .. my pain is chronic not continuous, i got severe pain may be 10 times in last 5 year, but getting more frequent lately..  3 times in last 1 year and lasts approx a week, I use hydrocodone with ibuprofen to control the pain.
I was unable to decide when to go for the surgery.. My specialist advices that post-pone it as much as i can .. but  i'm worried about how much damage it is going to do and also age / healing.

Is it better to go for surgery sooner? I am 41 yrs old, which surgery is recommended? PRC or 4 corner fusion?  Thanks a lot and good luck to all other guys who is planning for surgery. Thanks

[que19st]

How did you fusion surgery go?? I just had mine 2 weeks ago...

[que19st]

Hey guys. Im glad to know I am not the only one who is dealing with this. I'm learning more and more about this process. I'm a big sports person. Have been playing flag football for years. I just had the 4 corner fusion 2 weeks ago. Its been a pain. Knowing what I know now, I may have waited longer, but then again my wrist was hurting so I had to do it. So its been two weeks and the splint on my wrist bothers my incision area, wrist is sore at times, and my doc said I should be making a fist...... no where close. I'm worried about them having to go back in to clear up scar tissue to get more movement with my fingers. Anybody else with this issue? Also can anybody suggest another splint to use?

[debtdbb]

I am an active 53 yr old female who is scheduled to have a four corner fusion in a few weeksl. It is my dominant wrist and I am in constant pain. I have almost no flexion or extension in my wrist. At times, my whole right arm throbs and aches b/c the limited wrist movement has caused severe tendonitis in my elbow. Does anyone else have a problem with elbow tendonitis because of their limited wrist movement? I have my pre-op in a few days. Does anyone have some good questions I should ask my doctor?

[johnnyb612]

Just had my 4 corner fusion 2 weeks ago. I already have full movement of my fingers. However, my index finger and thumb are numb. I still have a bit if swelling in my hand. My doctor says for me to wait until cast comes off in 3 weeks. If numbness is still present, he will perform carpal tunnel surgery. Has anyone else had this issue? Over all I am very pleased with the results, just want the feeling back in my finger and thumb back