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CASE REPORT Bilateral Paradoxically Symptomatic Luno-triquetral Coalition: A Case Report
Oliver Lotter1, Stephane Stahl, Oliver Luz
1Department of Plastic, Hand and Reconstructive Surgery, Burn Center, BG Trauma Center, Eberhard-Karls, University Tübingen, Germany.
Eplasty
|July 3, 2010
Summary
Bilateral luno-triquetral coalition can present paradoxically, with bony unions causing pain and fibro-cartilage ones being asymptomatic. This challenges typical understandings of wrist coalition symptoms.
Area of Science:
- Orthopedics
- Hand Surgery
- Radiology
Background:
- Luno-triquetral coalitions are wrist joint fusions between the lunate and triquetrum bones.
- Bony coalitions are typically asymptomatic, while fibro-cartilaginous unions can cause ulnar-sided wrist pain.
Purpose of the Study:
- To report a rare case of bilateral luno-triquetral coalition with paradoxical symptoms.
- To discuss diagnostic approaches and treatment strategies for luno-triquetral coalition.
Main Methods:
- A case report of a 21-year-old female patient with bilateral luno-triquetral coalition.
- One wrist had a bony coalition causing pain; the contralateral wrist had a fibro-cartilaginous union that was asymptomatic.
Main Results:
- The symptomatic wrist had a stable bony coalition, leading to conservative management rather than fusion.
- Conservative treatment, including potential wrist denervation, was chosen for the symptomatic side.
Conclusions:
- Both complete and incomplete luno-triquetral coalitions can manifest as wrist pain.
- The biomechanical basis for this paradoxical presentation remains unclear, warranting further investigation.
