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The following case documentation shows the medical case history of a four-corner fusion in the SNAC wrist caused by a scaphoid fracture. The 50-year-old patient suffers from movement and rest pain before surgery and has corresponding movement restrictions in the wrist. After resection of the scaphoid bone, a four-corner fusion with three human bone grafts was performed. After 6 weeks of immobilization in a forearm cast, remedial gymnastics are started. One year after surgery, only traces of the bone screw graft are visible. The patient is free of pain and mobility has slightly improved.

X-Ray preoperatively

X-Ray shows SNAC-Wrist

4 days postoperatively

Radiographic follow-up after resection of the scaphoid and performed four-corner fusion with 3 bone screw grafts

6 weeks postoperatively

X-Ray during cast removal . Beginning of fusion cannot yet be seen with certainty

4 months postoperatively

Good bony union. Bone screw grafts begin to remodel into autologous bone

CT 1 year postoperatively

Complete fusion can be seen. CT shows no osteolysis or resorption zones. Patient in pain-free

Clinical case of Dr. Klaus Pastl, Linz in Austria. Four-corner fusion with three human bone screw grafts (documentation period 2010-2011) © surgebright GmbH

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