Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: General Orthopaedics
Abstract number: 26168
CARPAL SYNOSTOSIS-TWO CASE REPORTS
José E. FRAGA FERREIRA, Rui CERQUEIRA, Sofia VIÇOSO, Tiago BARBOSA,
Joăo Paulo OLIVEIRA, Tiago BASTO
Centro Hospitalar do Alto Ave, Guimarăes, EPE, Guimarăes (PORTUGAL)
The carpal synostosis, also known as coalitions are extremely rare congenital
anomalies, which occur as a result of a failure in the process of embryological
segmentation of the carpal bones, between the fourth and eighth weeks of embryonic
life. The bones carpal centers are separated by a cartilaginous undifferentiated
mesenchymal tissue that normally disappears, leaving empty spaces, which form the
carpal joints. A disruption of this process is caused by the persistence of band
cartilage between the bones that are subsequently ossified, and emerge as the
synostosis. The triquetrum-lunatum fusion is most common among all carpal
coalitions. It is present in between 0.08% and 0.13% of the population. The carpal
synostosis can be bilateral or unilateral but in most cases affects both hands. These
malformations are usually asymptomatic and diagnosis is often accidental. The
authors present two case of previously assintomatic patients that present in the
emergency department with wrist pain after a fall. The first case is a 10 years old girl
which showed a triquetrum-lunatum synostosis, and no sign of fracture or
degenerative signs. An x-ray of the contralateral wrist showed the same anomaly.The
second case is of a 13 years old boy that had suffered a fall a week ago and
presented in the emergency department because of persistent wrist pain. The X-ray
showed capitatum-hamatum synostosis. The contralateral side had no abnormality.
Again, there was no sign of fracture or degenerative signs.
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