Carpal coalition

Carpal coalition refers to failure of separation 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. 

Carpal fusion is a misnomer, as it is the failure of normal segmentation of carpal mesenchyme that results in the anomaly 8. Carpal coalition is less contentious as its definition means a connection between two bones, it says nothing about how they came to be connected 9.

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.

There are several associated conditions, especially with multiple coalitions:

As with tarsal coalition, congenital carpal coalition can either be osseous (synostosis), cartilaginous (synchondrosis), or fibrous (syndesmosis).

Non-syndromic 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.

The two most common types are:

Anatomy: Upper limb

Anatomy: Upper limb

Article information

rID: 10789
Section: Anatomy
Tag: carpus
Synonyms or Alternate Spellings:
  • Coalition of carpal bones

Support Radiopaedia and see fewer ads

Cases and figures

  • Case 1: luno-triquetral coalition
    Drag here to reorder.
  • Case 2: luno-triquetral coalition
    Drag here to reorder.
  • Case 3: luno-triquetral coalition
    Drag here to reorder.
  • Case 4: luno-triquetral coalition
    Drag here to reorder.
  • Case 5: capitato-trapezoid
    Drag here to reorder.
  • Case 6: extensive
    Drag here to reorder.
  • Case 7
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.