Synostosis and Coalitions of the Hand and Wrist

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.