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Pisiform-hamate coalition with ulnar neuropathy.

A R Berkowitz¹, C P Melone, M R Belsky

¹Hand Surgery Associates, Sacramento, CA 95816.

The Journal of Hand Surgery

|July 11, 1992

Summary

Pisiform-hamate coalition, a rare wrist condition, can cause ulnar nerve compression. This study reports two cases in white patients, highlighting a new clinical significance for this carpal coalition.

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Area of Science:

Orthopedics
Neurology
Anatomy

Background:

Carpal coalition is a rare congenital anomaly of the wrist bones.
Pisiform-hamate coalition was previously considered asymptomatic and exclusive to West African populations.

Observation:

Two cases of symptomatic pisiform-hamate coalition were identified in white patients.
Both patients presented with ulnar nerve compression at the wrist.

Findings:

This is the first documented instance of pisiform-hamate coalition causing ulnar neuropathy.
The findings challenge the previous understanding of this carpal coalition's prevalence and clinical relevance.

Implications:

Carpal coalitions should be considered in the differential diagnosis of wrist pain and neuropathy, regardless of ethnicity.
Further research is needed to understand the etiology and full clinical spectrum of pisiform-hamate coalition.

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