Bilateral STT Arthrodesis in a Young Patient with Occult Proximal Row Coalition

Author:

Wharton Rupert M.H.12ORCID,Ahearne David2

Affiliation:

1. Department of Hand Surgery, Pulvertaft Hand Centre, Royal Derby Hospital, Derby, United Kingdom

2. Department of Trauma and Orthopaedics, The Hillingdon Hospitals NHS Foundation Trust, Uxbridge, United Kingdom

Abstract

Abstract Background Carpal coalitions have an incidence of 0.1 to 1% in Caucasians and up to 8 to 9% in African populations. They rarely cause clinical problems requiring investigation or treatment, but are commonly identified on imaging obtained for other indications. Case Description We report a case of a 35-year-old male with progressive degenerative change of incomplete coalitions of the scaphotrapeziotrapezoid joint (STT) in the presence of bilateral complete osseous lunate–triquetral coalitions (Minnaar type 4). He was successfully treated with staged bilateral arthrodesis with excellent symptom resolution and preservation of function. Literature Review In patients with isolated STT coalition six reports of surgery exist, two of which were for arthrodesis. This is the first described case of STT arthrodesis in a patient with coexistent lunate–triquetral coalition. Clinical Relevance The STT arthrodesis remains a safe and effective treatment for STT pain even in cases of occult carpal coalition. Functional range of movement was well preserved. Level of evidence This is a Level V study.

Publisher

Georg Thieme Verlag KG

Subject

Orthopedics and Sports Medicine,Surgery

Reference18 articles.

1. Carpal coalitions on radiographs: prevalence and association with ordering indication;B T van Hoorn;J Hand- running titlec Surg Am,2017

2. Carpal coalitions and metacarpal synostoses: a review;M B Gottschalk;Hand (N Y),2016

3. The surgical management for isolated scaphotrapeziotrapezoid (STT) osteoarthritis: a systematic review of the literature;S Jehan;Acta Orthop Belg,2020

4. Scaphotrapeziotrapezoid arthrodesis: a 10-year follow-up study of complications in 58 wrists;M J Rogers;Hand (N Y),2020

5. Short report letter: combined bilateral carpal coalition of the scaphoid and trapezium and of the lunate and triquetrum;S S Nagel;J Hand Surg Eur Vol,2018

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