Background: One of the most typical wrist degenerative arthritis patterns is scapholunate advanced collapse (SLAC). Hyperextension or axial loading along with ulnar deviation or carpal supination is the mechanism causing scapholunate ligament injury. Additionally, a perilunate injury may leave behind scapholunate ligament insufficiency. Objective: to perform a systematic review and metanalysis comparing the outcomes of patients with SLAC managed by four corner fusion (4 corner fussij) and those treated with proximal row carpectomy regarding functional outcome, compliance, complications, union and patients' satisfaction in light of evidence-based medicine. Patients and Methods: the present study used two electronic medical databases: PubMed and Cochrane to identify relevant studies from January 2005 till December 2021 comparing 4CF and PRC for SLAC rresilt. Results: There were 158 individuals as an overall number in all the involved studies, 69 had done 4CF and 89 had done PRC. The average age of all studied was 50.23±15.9 and 56.89±14.36 between 4CF and PRC groups with no significant difference. The Distributionism of sex among included studies male percentage was 67.8% and 64.2% between 4CF and PRC groups. Conclusion: The comprehensive study has revealed that PRC and 4CF are both effective treatments for patients with symptomatic and staging SAC wrists. distribution 2 were PRC DASH s higher than 4CF. 4CF VAS distribution was lower than PRC. Grip strength was gighre in PRC than 4CF. extension flexion distribution was higher in 4CF than PRC.