Purpose
The primary objective of this study was to compare incidence, demographic trends,
and rates of subsequent fusion between proximal row carpectomy (PRC) and 4-corner
fusion (4CF) among patients in the United States.
Methods
A total of 3,636 patients who underwent PRC and 5,047 who underwent 4CF were identified
from the years 2005 through 2014 among enrollees in the PearlDiver database. Regional
distribution, demographic characteristics, annual incidence, comorbidities, and subsequent
wrist fusion were compared between the 2 groups. Of the patients identified, 3,512
from each group were age- and sex-matched and subsequently compared for rates of converted
fusion, 30- and 90-day readmission rates, and average direct cost.
Results
Patients undergoing 4CF and PRC did not have statistically significant differences
in comorbidities. The incidence of the procedures among all subscribers increased
for both PRC (1.8 per 10,000 to 2.6 per 10,000) and 4CF (1.2 per 10,000 to 2.0 per
10,000) from 2005 to 2014. Comparing the matched cohorts, patients who underwent 4CF
had a higher rate of subsequent fusion than those who underwent PRC (2.67% vs 1.79%).
Readmission rates were not significantly different at 30 or 90 days. Average direct
cost was significantly greater for 4CF than for PRC.
Conclusions
Both PRC and 4CF have been utilized at increasing rates in the past decade. Wrist
fusion rates and average costs are higher in the 4CF group without a significant difference
in readmission rates.
Type of study/level of evidence
Therapeutic III.
Key words
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Article info
Publication history
Published online: February 20, 2020
Accepted:
December 31,
2019
Received:
January 4,
2019
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2020 by the American Society for Surgery of the Hand. All rights reserved.
