RESUMO
Kienböck disease, or lunate avascular necrosis, can lead to chronic wrist pain and instability. Its etiology appears to be multifactorial including variations in adjacent anatomical structures, interrupted blood supply, and trauma. Capitate-hamate fusion is the second most commonly diagnosed carpal coalition and not treated unless symptomatic. Coalitions may alter the wrist mechanics depending on their extent. No prior reports have associated Kienböck disease with capitate-hamate coalition. We present 2 cases with congenital capitate-hamate fusion and lunate AVN.
Assuntos
Capitato/anormalidades , Anormalidades Congênitas/diagnóstico por imagem , Hamato/anormalidades , Osteonecrose/complicações , Osteonecrose/diagnóstico por imagem , Articulação do Punho/fisiopatologia , Adulto , Artralgia/diagnóstico , Artralgia/etiologia , Autoenxertos , Transplante Ósseo/métodos , Capitato/diagnóstico por imagem , Ossos do Carpo/anormalidades , Ossos do Carpo/diagnóstico por imagem , Anormalidades Congênitas/cirurgia , Feminino , Hamato/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Osteonecrose/fisiopatologia , Osteotomia/métodos , Radiografia/métodos , Doenças Raras , Estudos de Amostragem , Resultado do Tratamento , Articulação do Punho/diagnóstico por imagemRESUMO
We present a case of symptomatic, incomplete bony carpal coalition between capitate and trapezoid. We describe previous case reports and possible therapeutic options.
Assuntos
Capitato/anormalidades , Deformidades Congênitas da Mão/diagnóstico , Trapezoide/anormalidades , Diagnóstico Diferencial , Diagnóstico por Imagem , Humanos , Masculino , Adulto JovemRESUMO
Carpal coalition is a rare wrist anomaly. A coalition can be an isolated condition, but it can be observed as a component of a congenital syndrome as well. Carpal coalition is usually asymptomatic and detected incidentally. It is most frequently encountered as lunate-triquetral coalition, followed by capito-hamate coalition. Other coalition types are very rare. In this case report, we present a case in which the patient applied with complaints of pain, and in whom a coalition of capitate-trapezoid- second and third metacarpal was detected.
Assuntos
Capitato/anormalidades , Ossos Metacarpais/anormalidades , Trapezoide/anormalidades , Articulação do Punho/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Radiografia , Amplitude de Movimento ArticularAssuntos
Artralgia/etiologia , Capitato/anormalidades , Articulações do Carpo/anormalidades , Hamato/anormalidades , Adolescente , Artralgia/tratamento farmacológico , Capitato/diagnóstico por imagem , Articulações do Carpo/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Feminino , Glucocorticoides/uso terapêutico , Hamato/diagnóstico por imagem , Humanos , Injeções Intra-Articulares , Escala Visual AnalógicaRESUMO
We reviewed retrospectively seven patients with Apert acrosyndactyly and measured the size of the capitate ossification centre relative to that of the hamate and determined the relative position of the middle finger metacarpal relative to the ring finger metacarpal. We then compared those parameters in 197 normal children. In all patients, the middle finger metacarpal bone had migrated proximally relative to the ring finger metacarpal and the size of the capitate ossification centre was smaller than that of the hamate. After surgical release of the middle finger, relative proximal migration of the middle finger metacarpal was partially relieved and catch-up growth of the capitate was observed within several months. As fusion of the distal phalanges creates a diamond-shaped configuration, bone growth is markedly impaired in the middle finger ray. Therefore, early separation of the middle finger may be as important as early separation of the border digits.