Four corner arthrodesis for preiser’s disease – 15 year follow up

Background: Atraumatic, idiopathic, avascular necrosis of carpal scaphoid – Preiser’s disease is a very rare disease. Since the condition is so uncommon there is no clear therapeutic recommendation.Methods: A 15 year’s follow-up of a patient with complete avascular necrosis of the scaphoid is presented. He was treated with subtotal excision of scaphoid and four corner arthrodesis. The patient was invited for a control three and fifteen years after surgery. Range of movement, grip power, pain and satisfaction with the procedure was measured with the Mayo Wrist Score (MWS). Functional ability of his arm was measured with Dissability of Arm and Shoulder (DASH).Results: Independent examiner measured his functional ability with MWS where he got 65 points out of 100. The patient fulfilled DASH questionary where he gained 6.6 points (0 is the best, 100 is the worst). Results didn’t change between the control three and fifteen years after surgery.Conclusions: Similary to some other authors we concluded that four corner arthrodesis is a reliable procedure for advanced stages of Preiser’s disease.