Some Observations on Certain Congenital Abnormalities of the Hand in African Natives

Smitham, J. Hillyer

doi:10.1259/0007-1285-21-250-513

Cited by 29 publications

(9 citation statements)

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“…The anthropological significance of this anomaly has been the subject of longstanding debate [35]. Since coalition of the carpus is almost always an incidental finding, it may have anthropologic importance -possibly representing an [8].…”

Section: Anthropological Significancementioning

confidence: 99%

“…This may be particularly true for non-osseous coalitions, in which deficient intraarticular cartilage formation may lead to a clinical and anatomical state resembling degenerative arthritis [14]. Furthermore, persistence of grooves, notches, and cavities at the fusion site appears to be a contributing factor toward the predisposition to fractures in patients with osseous coalition [3,34,35]. Asymptomatic or mildly symptomatic cases of coalition rarely require anything more than conservative management.…”

Section: Clinical Significance and Management Of Symptomatic Of Intermentioning

confidence: 99%

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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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Section: Anthropological Significancementioning

confidence: 99%

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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“…In cases of trauma, the extended hamuluspisiform block may act as a lever transmitting force to the body of the hamate, and predisposing affected individuals to fracture (Ganos and Imbriglia, 1991). A similar predisposition to fracture has been previously noted in osseous lunate-triquetral coalition, particularly in cases involving a notch between the united carpals (Smitham, 1948;Cockshott, 1959).…”

Section: Clinical Significancementioning

confidence: 62%

Hamate‐pisiform coalition: Morphology, clinical significance, and a simplified classification scheme for carpal coalition

Burnett

2010

Clinical Anatomy

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Hamate-pisiform coalition is characterized by the abnormal union of the pisiform bone and hamulus of the hamate. Because most reported cases are isolated, and literature on the subject is sparse, relatively little is known about this condition and its clinical significance. The purpose of this report is to discuss the occurrence, morphology, and frequency of hamate-pisiform coalition identified in a skeletal sample of native South Africans, and to conduct a metaanalysis of all known cases in order to clarify the sex distribution, laterality, form, and clinical significance of this condition. Five new cases (three male, two female) of hamate-pisiform coalition were identified in 527 native South Africans. Results indicate that hamate-pisiform coalition is infrequent (0.76%) but may be more likely encountered in individuals of African ancestry. Morphologically, non-osseous examples ranged in appearance from minor expressions involving pitting of an expanded hamulus base, to a variably pitted articulation between an elongated pisiform and hamulus. Osseous union between the two bones tends to extend beyond the hamulus base to adjacent areas of the hamate. Cases involving osseous union appear predisposed to fracture while ulnar neuropathy is significantly more frequent in individuals exhibiting non-osseous coalition. As both non-osseous and osseous cases can have clinical significance, awareness of the variable manifestations of this condition is necessary for hand specialists. A simplified classification system is suggested to more consistently characterize carpal coalitions.

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“…As pointed out by Resnik et al, several examples of incomplete lunato-triquetral coalition with subarticular radiolucencies had been previously reported. Those cases were described as a fracture of a fused bone with established nonunion and cyst formation [4], a fracture with a few small cysts [16], incomplete or partial fusion resembling pseudoarthrosis [9,17], pseudoarthrosis [13,18], or osteoarthritis. In some cases the abnormality was not described despite the presence of incomplete fusion on images of the opposite hand in two different patients [19].…”

Section: Discussionmentioning

confidence: 99%

Symptomatic fibrous lunato-triquetral coalition

et al. 1999

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In general, carpal coalitions are considered to be asymptomatic. Incomplete separated joints and associated changes similar to osteoarthritis and pseudoarthrosis are known as possible causes of wrist pain. We present the clinical history, plain-film, and MR imaging findings of two patients with symptomatic fibrous lunato-triquetral coalition. Conventional films disclosed a narrowed space between the lunate and triquetral bone with cysts and sclerosis similar to pseudoarthrosis. Magnetic resonance imaging showed bone marrow edema adjacent to the incomplete separated lunato-triquetral joint and Gd-DTPA enhancing fibrovascular tissue in the synovium and subarticular cysts, explaining the pain over the ulnar-sided wrist. Patients with congenital lunato-triquetral coalition may poorly tolerate stress loading or trauma, resulting in a symptomatic state similar to degenerative arthritis or pseudoarthrosis, which is demonstrated by enhanced MR imaging.

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Some Observations on Certain Congenital Abnormalities of the Hand in African Natives

Cited by 29 publications

References 1 publication

Carpal Coalition

Carpal Coalition

Hamate‐pisiform coalition: Morphology, clinical significance, and a simplified classification scheme for carpal coalition

Symptomatic fibrous lunato-triquetral coalition

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