Lunotriquetral coalition
Updates to Article Attributes
Lunotriquetral coalition is the most common type of carpal coalition and represents a congenital fusion of the lunate and triquetral bones of the carpus.
Epidemiology
Lunotriquetral coalition is the most common type of carpal coalition with a prevalence of 0.1%. It is more common in females (F:M = 2:1) and African Americans.
Clinical presentation
Whilst osseous coalitions of the lunate and the triquetrum are known to be asymptomatic, fibrocartilaginous lunotriquetral coalitions can present as an uncommon cause of ulnar-sided wrist pain often due to the pseudarthrosis or a post-traumatic disruption 3,8.
Pathology
- coalition may be fibrous, cartilaginous or osseous 5
- commonly bilateral 4
Carpal coalitions can follow an autosomal dominant route of inheritance
Classification
de Villiers classified lunotriquetral coalition into four types 6:
- incomplete (or fibrocartilaginous) fusion - resembles a pseudoarthrosis
- incomplete osseous fusion
- complete osseous fusion
- complete osseous fusion with other carpal abnormalities
Radiographic features
Plain radiograph
- coalition of the lunate and triquetrum
- may be accompanied by a widened scapholunate interval 4
Treatment and prognosis
Most commonly an incidental finding. May occasionally be the cause of chronic wrist pain (especially in types 1 and 2 6) and, of course, can be fractured.
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Image 13 X-ray (Ball-catcher view) ( create )
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