The Spider™ Limited Wrist Fusion Plate (8-holes)
can be utilized in various locations throughout
the wrist depending on the procedure being performed.
The plate has been used successfully for:
Luno-triquetro-capito-hamate
(four corner) fusion
Scaphocapitate (SC) fusion
Radioscapholunate (RSL) fusion
Scapholunacapitate (SLC) fusion
Scaphotrapezium trapezoid (STT) fusion
Preparation of the site to be fused and
the specific techniques are fairly similar regardless
of where the fusion is desired. The larger Spider™
plate’s design is optimized for four-corner
limited arthrodesis. The plate can also be utilized
for other limited wrist fusion procedures for
which the plate is appropriately sized.
Skin Incision and Exposure
A longitudinal incision is made centered over
the dorsal wrist or a transverse incision can
be utilized (Figure 1)
Dissection is carried down through the subcutaneous
tissues taking care to protect the sensory branch
of the radial and ulnar nerve fibers
Exposure for SLAC Deformities
that Require Scaphoid Excision
Exposure is undertaken through the third dorsal
compartment transposing the extensor pollicis
longus tendon radially
The incision is taken from the third compartment,
between the second and fourth compartments, distally
through the capsule exposing the scaphoid
The scaphoid is generally removed using a rongeur,
taking care to protect the extrinsic ligaments
A radial styloidectomy may be indicated
Exposure of the four-bone region encompassing
the lunate, triquetrum, capitate, and hamate can
be undertaken through this incision (Figure 2)
Additional Incision Options
A separate longitudinal incision can be made
between the fourth and fifth compartments, or
an anatomical dorsal ligament-sparing approach
can be used for direct exposure to the four-bone
region
These techniques are also utilized in patients
who undergo a four-corner fusion for stability
alone where the scaphoid does not require excision
