Twenty eight patients with advanced carpal collapse (20 with scapho-lunate advanced collapse [SLAC] and 8 with scaphoid-nonunion advanced collapse [SNAC]) who were treated with a four-corner arthrodesis were reviewed; 23 had a good or excellent outcome. The mean DASH score was 41. The flexion/extension arc decreased from 72° to 52°. Gripping force increased from 46% to 72%. The range of motion was better in those with traditional fixation (K-wires or screws) compared to the newer circular plates. There was no significant difference concerning pain relief, gripping force and disability.