Anomalous Fusion Between the Lunate and Triquetrum

SUMMARY:The morphology and morphometry of the distal articular surface of the lunate exhibits inter-population variations. They are of clinical importance to hand surgeons due to their influence on the occurrence of proximal pole arthrosis which is a cause of ulnar-side wrist pain. The objective of the study was to determine the morphology and morphometry of the distal articular surface of the lunate bone in an adult Kenyan population. A descriptive cross-sectional study at the Department of Human Anatomy, University of Nairobi. Fifty-six human hands obtained for routine dissection were used. The morphology of the distal articular surface of the lunate was classified as either Type I or Type II depending on the absence or presence of a medial facet for articulation with the hamate respectively. The width of the wrists and of the medial facet in Type II lunates was measured with SOMETTM CN-25 1234 vernier calipers (accurate to 1mm). Photomacrographs of representative lunate were taken. Data were analyzed using SPSS version 17.0. The Pearson correlation test was used to check for any correlations. Type II lunate morphology was more common with a prevalence of 34 (61 %) while 19 (34 %) were Type I. The mean width of wrists with Type I lunate was 41.1±2.8 mm while those with Type II had a mean width of 46.1±4.3 mm. The mean width of the medial facet in lunate type II was 4.4±1.4 mm. Lunotriquetral fusion was demonstrated in 3 (5 %) wrists. Prevalence of Type II lunate was higher than Type I. Wrists with a Type II lunate were wider than those with Type I. There was no correlation between the width of the wrist and the width of the medial facet of the lunate.

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“…This is consistent with literature reports of 9 % among blacks (Szaboky et al, 1969). Carpal bone coalition may be congenital or acquired.…”

Section: Discussionsupporting

confidence: 93%

Morphology and Morphometry of the Distal Articular Surface of Lunate Bone in a Kenyan Population

et al. 2016

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“…Among the various populations studied, the highest prevalence of this anomaly is seen in individuals of West African descent, with reports as high as 9.5 % in some groups [4,13,32,33]. In the American population, the prevalence ranges between 0.08 % and 0.13 % [37], with an estimated frequency of 0.1 % among white Americans and 1.6 % among Americans of African origin [13]. Second in frequency is coalition between the capitate and hamate, which demonstrates similar variations in prevalence.…”

Section: Prevalence Of Coalition Anomalies Of the Handmentioning

confidence: 99%

“…Neither osseous nor non-osseous coalition appears to have a discernible effect on wrist function [8,37]. However, symptoms may manifest by virtue of the biomechanical alterations that result from structural fusion at the wrist [34].…”

Section: Clinical Significance and Management Of Symptomatic Of Intermentioning

confidence: 99%

Carpal Coalition

DeFazio

Cousins

Miversuski

et al. 2013

Hand (New York, N,Y.)

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Background Carpal coalition is a relatively common, yet poorly recognized, anomaly that may present independently or in association with syndromic or metabolic disorders. While largely asymptomatic, symptoms may manifest secondary to biomechanical stress at the site of fusion. The purpose of this report is to describe 103 cases of carpal synostosis and provide a review of the etiology, classification, and clinical significance of intercarpal fusion. Methods Retrospective review of medical and radiographic records was conducted on all patients with identified carpal coalitions, between 2008 and 2012, at our institution. Demographic and historical data regarding trauma, infection, documented joint disease, and prior wrist symptomatology were analyzed for each case, and radiographic evaluation of carpal alignment was performed. Results A total of 103 cases of carpal coalition, among 85 individuals, were reviewed. All cases presented asymptomatically with the highest proportion noted among individuals of African-Caribbean descent. The most frequent variant in our study population was lunate-triquetral coalition, which was present in 92 of the 103 identified cases. None of the cases evaluated in this study demonstrated clinical or radiographic evidence of carpal mal-alignment or instability. Conclusion The results of our investigation demonstrate that carpal coalition presented most frequently among individuals of African-Caribbean descent. While the prevalence of this condition has yet to be studied specifically in Hispanic and African-Caribbean populations, our findings may reflect the genetic linkage between these and certain West African populations. To our knowledge, this represents the largest clinical series of carpal coalition in the English literature.

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“…1 There may be variation in the blood supply of the normal scaphoid and lunate bones. Therefore, the blood supply to the scapholunate bone can be established by one or a few small arteries.…”

Section: Discussionmentioning

confidence: 99%

“…While its incidence is 0.1% in whites, it rises up to 9.5% in some societies living in the West Africa. 1,2 There are two types, which are osseous and non-osseous. 3 The carpal bones that form coalition in the osseous type create a single block bone by combining with each other.…”

Section: Introductionmentioning

confidence: 99%