Carpal coalition
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Carpal coalition refers to fusion of two or more carpal bones, and although the most commonly involved bones are the lunate and triquetrum, most combinations of adjacent bones can be found to be coalesced.
Epidemiology
The estimated prevalence is ~0.1% in Caucasian Americans and ~1.5% in African Americans, and it tends to affect women more commonly 1-2.
Aetiology
Non-syndromatic congenital carpal coalition is transmitted via a mendelian inheritance pattern. Acquired intercarpal fusion can either be a consequence of an inflammatory arthropathy (e.g.rheumatoid arthritis, psoriatic arthritis, reactive arthritis) or injury, or due to intentional surgical arthrodesis.
Pathology
As with tarsal coalition, congenital carpal coalition can either be osseous (synostosis), cartilaginous (synchondrosis), or fibrous (syndesmosis).
Types
The two most common types are:
- luno-triquetral coalition: much more common than all other types combined
- capito-hamate coalition
Associations
There are several associated conditions, especially with multiple coalitions:
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