Wrist, PRC, and Four Corner Fusion

The radiocarpal joints, the scaphoid, lunate, and triquetrum bones that have been most affected.

Total or Partial Wrist Fusion

A partial wrist fusion involves fusing the radiocarpal joints that have been most affected by arthritis while a total wrist fusion involves fusing the whole radiocarpal joint. This may be done with screws, plates, or staples. In this case, the patient will be sacrificing wrist motion for pain relief. Recovery will involve immobilization for about 6 weeks while the fusion heals.

Total or Partial Wrist Fusion​ Modern Orthopaedics of New Jersey, Wayne, Parsippany, Dr. Peter DeNoble MD and Dr. David Ratliff MD. Orthopedic Surgeons, Hand Surgeon
Total or Partial Wrist Fusion​ Modern Orthopaedics of New Jersey, Wayne, Parsippany, Dr. Peter DeNoble MD and Dr. David Ratliff MD. Orthopedic Surgeons, Hand Surgeon

Four Corner Fusion

A four corner fusion is one technique in which midcarpal arthritis can be addressed surgically. This procedure involves removing the scaphoid bone and fusing together four of the remaining carpal bones. This is usually reserved for patients with a well preserved radiolunate joint and isolated midcarpal arthritis. The capitate, lunate, hamate, and triquetrum are fused together with screws or large metal staples. This eliminates motion between these bones but preserves some motion at the wrist. These bones will fuse together into one bone with no joint space over time. The goal of this surgery is to eliminate pain caused by midcarpal arthritis and allow the patient to return to having a functional pain free hand and wrist.

Four Corner Fusion​
Four Corner Fusion​ Modern Orthopaedics of New Jersey, Wayne, Parsippany, Dr. Peter DeNoble MD and Dr. David Ratliff MD. Orthopedic Surgeons, Hand Surgeon

Proximal Row Carpectomy

A proximal row carpectomy involves removing the scaphoid, lunate, and triquetrum bones. This may be used in patients with Kienbock’s disease (avascular necrosis of the lunate), scaphoid nonuion, SLAC (scaphoid lunate advanced collapse) or SNAC (scaphoid nonunion advanced collapse) wrist. It is usually not a good option for patients with advanced arthritic changes. The goal of the surgery is to remove the bones causing pain while allowing the patient to retain some motion. The recovery time is generally quicker following this procedure because you do not need to wait for any bones to fuse or heal before returning to activities.

Proximal Row Carpectomy​ Modern Orthopaedics of New Jersey, Wayne, Parsippany, Dr. Peter DeNoble MD and Dr. David Ratliff MD. Orthopedic Surgeons, Hand Surgeon
DRUJ Instability/Arthritis, Ulnocarpal Impaction, DIP Pinning for Mallet Finger

Benefits

The orthopedic surgeons here are also specially trained in the field of hand and wrist surgery and treat all conditions, from very straightforward to the most complex. Furthermore, we believe that even the simplest problems of the hand and wrist deserve evaluation from a hand specialist who has an expertise in understanding of the intricate anatomy of the hand.

Every Patient Matters

Every patient receives an in-depth consultation to devise a treatment plan that is right for their problem. Our specialists prefer non-operative and non-invasive treatments whenever possible, including physical therapy, medications, and/or injections. When we require surgery, we will then use minimally invasive surgical techniques to fix your problem, whether it is fixing a broken bone or repairing a tendon. Our goal is always to get you back to living your life normally as soon as possible.

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Please call us at (973) 898-5999.