Arch Hand Microsurg.  2024 Dec;29(4):252-257. 10.12790/ahm.24.0038.

Bilateral lunotriquetral coalition in a military cook: a case report and review of the literature

• Kim JS
• Ahn BH
• Ha C

• KMID: 2561375
• DOI: http://doi.org/10.12790/ahm.24.0038

Abstract

Carpal coalitions are congenital conditions that can cause ambiguous wrist pain and should be considered as a rare possibility in the differential diagnosis, especially in screening settings such as military hospitals. This case report presents the first domestic report of bilateral lunotriquetral coalitions in a 21-year-old military cook who presented with bilateral wrist pain. A radiographic evaluation confirmed a Minnaar type 3 complete osseous coalition. After conservative treatment, the symptoms improved. This case was rare in the Korean context, and the report provides various radiological images along with a review of previously reported cases in the Korean literature.

Keyword

Carpal bones; Coalition; Lunate bone; Triquetrum bone

Figure

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  Fig. 1. Range of motion in both wrists.

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  Fig. 2. (A) A simple wrist plain radiograph reveals bilateral lunotriqueral coalitions. (B) Three-dimensional computed tomography shows complete osseous connection between the lunate and triquetrum; Minnaar type 3. RT, right; LT, left.

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  Fig. 3. T2-Weighted coronal sequence of magnetic resonance imaging shows joint effusion and thinning of the scapholunate ligament. RT, right; LT, left.

Reference

References

1. Poznanski AK, Holt JF. The carpals in congenital malformation syndromes. Am J Roentgenol Radium Ther Nucl Med. 1971; 112:443–59.

2. Defazio MV, Cousins BJ, Miversuski RA Jr, Cardoso R. Carpal coalition: a review of current knowledge and report of a single institution's experience with asymptomatic intercarpal fusion. Hand (N Y). 2013; 8:157–63.

3. Devilliers Minnaar AB. Congenital fusion of the lunate and triquetral bones in the South African Bantu. J Bone Joint Surg Br. 1952; 34-B:45–8.

4. Won EY, Bae MK, Kim MW, Song SH, Rhee SK. Bilateral congenital carpal coalition: case report. J Korean Surg Hand Soc. 2008; 13:76–8.

5. Seo JS, Lee EK, Oh JT, Kim CT. Two cases of congenital carpal coalition with pain of the wrist. Korean J Med. 2010; 79:457–60.

6. Choi HY, Kim JH, Min HJ, Kim JW. Isolated symptomatic scapho-lunate coalition without accompanying anomalies. J Korean Orthop Assoc. 2018; 53:449–52.

7. Ali R, Khan F, Saeed S, Javed N. Lunotriquetral coalition: an unusual cause of wrist pain. Cureus. 2019; 11:e5704.

8. Resnik CS, Grizzard JD, Simmons BP, Yaghmai I. Incomplete carpal coalition. AJR Am J Roentgenol. 1986; 147:301–4.

9. Metz VM, Schimmerl SM, Gilula LA, Viegas SF, Saffar P. Wide scapholunate joint space in lunotriquetral coalition: a normal variant? Radiology. 1993; 188:557–9.

10. Stäbler A, Glaser C, Reiser M, Resnick D. Symptomatic fibrous lunato-triquetral coalition. Eur Radiol. 1999; 9:1643–46.