Carpal Coalition

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X-ray image of the Lunotriquetral Coalition. It is the most common form of the Carpal coalition.

A carpal coalition is a solid connection between carpal bones , which are usually in contact through a joint . This connection can be bony ( synostosis ), cartilaginous ( synchondrosis ) or connective tissue ( syndesmosis ). The cause is assumed to be inadequate differentiation of the carpal bones between the 4th and 8th week of embryo.

Epidemiology

The frequency of carpal coalitions is given as about 0.1% of the population, although it seems to be significantly higher for people of African origin. The gender ratio is given as 2: 1 (male: female). There is a familial accumulation. The bony abnormality usually occurs on both hands. If it is one-sided, the left hand is more often affected.

to form

When a carpal coalition occurs in isolation, which is the more common case, two bones in the same carpal row are usually affected; when syndromes or other more global disorders occur, connections between several bones in both rows also occur. By far the most common fused bones of the carpal bone are the lunate and triquetrum, followed by the hamate and capitate .

Symptoms and Therapy

A firm bony connection is usually found by chance as it does not cause any problems. The much rarer incomplete or connective tissue connections are more difficult, since symptoms similar to pseudarthrosis can occur here due to the remaining mobility . In these cases, the therapy can be a complete stiffening, i.e. arthrodesis .

Differential diagnosis

Arthritic fusions of the carpal bones

A fusion of the carpal bones can also be secondary in inflammatory diseases such as B. juvenile idiopathic arthritis occur.

See also

Web link

Commons : Carpal Coalition  - Collection of Images

Individual evidence

  1. ↑ a b c d A. Martini (Ed.) Elbow, forearm, hand. In: C. Wirth, L. Zichner: Orthopedics and orthopedic surgery. Thieme, 2003, ISBN 3131262117
  2. ↑ a b N. Samir, A. Al-Mahrezi: Congenital fusion of the trapezium and trapezoid. In: Sultan Qaboos University medical journal. Volume 10, Number 3, December 2010, ISSN  2075-0528 , pp. 405-406, PMID 21509264 , PMC 3074740 (free full text).
  3. ↑ a b M. E. Timins: Osseous anatomic variants of the wrist: findings on MR imaging. In: American Journal of Roentgenology . Volume 173, Number 2, August 1999, ISSN  0361-803X , pp. 339-344, doi : 10.2214 / ajr.173.2.10430131 , PMID 10430131 .
  4. ^ BP Simmons, WD McKenzie: Symptomatic carpal coalition. In: The Journal of hand surgery. Volume 10, Number 2, March 1985, ISSN  0363-5023 , pp. 190-193, PMID 3980929 .
  5. ↑ MV Defazio, BJ Cousins, RA Miversuski, R. Cardoso: Carpal coalition: A review of current knowledge and report of a single institution's experience with asymptomatic intercarpal fusion. In: hand. Volume 8, Number 2, June 2013, ISSN  1558-9447 , pp. 157-163, doi : 10.1007 / s11552-013-9498-5 , PMID 24426912 , PMC 3653005 (free full text)
  6. ↑ MJ Ritt, M. Maas, KE Bos: Minnaar type 1 symptomatic lunotriquetral coalition: a report of nine patients. In: The Journal of hand surgery. Volume 26, Number 2, March 2001, ISSN  0363-5023 , pp. 261-270, doi : 10.1053 / jhsu.2001.21520 , PMID 11279572 .