Spider plate fixation: no significant improvement in limited wrist arthrodesis.

Using the Spider plate fixation device, limited wrist arthrodesis was performed on 30 patients over a 2-year period. Developed as an alternative to Kirschner wires and compression bone screws in limited intercarpal fusions, its rigid fixation was expected to yield better results. Five hand surgeons treated 24 men and 6 women with an average age of 45 years. Diagnosis included the following: scaphoid nonunion advanced collapse, scapholunate advanced collapse, scapholunate dissociation, midcarpal arthrosis, and Kienböck disease. The 8-hole regular Spider and 6-hole mini-Spider plates were applied dorsally, and patients were immobilized for 4 weeks. In a blinded study, data results showed no significant improvement when compared with bone screws and Kirschner wires. Preliminary results showed that the Spider plate yielded higher nonunion rates and less wrist motion.