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Synostosis and Coalitions of the Hand and Wrist

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Congenital Anomalies of the Upper Extremity

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Abstract

Congenital carpal coalitions are uncommon. The incidence is variable with respect to race, with African Americans having a higher percentage. These coalitions can be either isolated or associated with a syndrome. Isolated carpal coalitions most frequently occur between the lunate and triquetrum; however, coalitions have been described between almost all adjacent carpal bones. When carpal coalitions are associated with a syndrome, multiple carpal bones can be involved. Most inter-carpal coalitions are asymptomatic and are usually discovered as incidental findings during radiographic evaluation following a traumatic event. Patients with symptomatic carpal coalitions tend to have incomplete coalitions.

Metacarpal synostosis is a rare entity characterized by the coalescence of two adjacent metacarpals. The most common form is between the ring and little finger metacarpals and is associated with abduction of the little finger in an awkward position. Multiple treatment options exist to correct the deformity, but close follow-up in skeletally immature patients is required given the potential for recurrence.

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Authors and Affiliations

  1. Clinical Affiliate Faculty, Dell Children’s Medical Center of Central Texas, University of Texas at Austin, Austin, TX, USA

    Hilton P. Gottschalk

  2. Department of Orthopaedic Surgery, Loyola Stritch School of Medicine, Maywood, IL, USA

    Terry R. Light

  3. Shriners Hospital, Chicago, IL, USA

    Terry R. Light

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  1. Hilton P. Gottschalk
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  2. Terry R. Light
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Correspondence to Terry R. Light .

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  1. Colchester, VT, USA

    Donald R. Laub Jr.

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Gottschalk, H.P., Light, T.R. (2021). Synostosis and Coalitions of the Hand and Wrist. In: Laub Jr., D.R. (eds) Congenital Anomalies of the Upper Extremity. Springer, Cham. https://doi.org/10.1007/978-3-030-64159-7_18

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  • DOI: https://doi.org/10.1007/978-3-030-64159-7_18

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