Abnormal anatomy of carpal bones is uncommon. We report on a multitrauma patient that, was initially misdiagnosed as scaphoid dislocation, which later was proven to be pisiform hamate coalition.
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Accuracy of a Superficial Landmark of the Recurrent Branch of the Median Nerve and Anatomical Features of Transverse Muscle Fibres Observed During Carpal Tunnel Release.
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January 2025
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Surgeons use anatomical landmarks like the scaphoid tubercle, pisiform, trapezial tubercle and hook of hamate, along with Kaplan cardinal line (KCL) to avoid injury to the recurrent motor branch (RMB) of the median nerve during carpal tunnel release. The presence of transverse muscle fibres (TMF) overlying the transverse carpal ligament (TCL) may suggest proximity of the RMB, but their anatomical relationship is unclear. In this study, we evaluated the accuracy of anatomical landmarks to the RMB, TMF origin and insertion, and examined the relationship between TMF presence and RMB running patterns.
View Article and Find Full Text PDFCombination of morphological and multiparametric MR neurography enhances carpal tunnel syndrome diagnosis and evaluation.
Sci Rep
January 2025
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
This study aimed to investigate the diagnostic and evaluative significance of combining median nerve (MN) morphological measurements with diffusion tensor imaging (DTI) and T2 mapping metrics for carpal tunnel syndrome (CTS). Morphological and multiparametric magnetic resonance neurography (MRN), along with clinical evaluation, were conducted on 33 CTS patients and 32 healthy controls. The MRN metrics included fractional anisotropy (FA), apparent diffusion coefficient (ADC), axial diffusivity (AD), radial diffusivity (RD), T2 value, cross-sectional area (CSA) and MN flattening ratio (MNFR) at both the pisiform bone and hamate bone levels.
View Article and Find Full Text PDFSymptomatic Congenital Coalition of the Pisiform and Hamate - A Case Report.
J Hand Surg Asian Pac Vol
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Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan.
We describe a 13-year-old boy with piso-hamate coalition confirmed by X-ray. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed type 1 coalition according to the classification of DeVilliers Minnaar. Piso-hamate coalition is rare, and suspicions should be raised in instances of chronic ulnar-sided wrist pain, particularly in individuals with a history of elevated hand usage, especially amongst athletes engaging in intensive hand grip activities.
View Article and Find Full Text PDFIsolated Osseous Excision in the Adult Carpus: A Narrative Review.
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Department of Orthopaedic Surgery, Medical College of Georgia, Augusta, Georgia, United States.
Various pathologies of the adult carpus result in clinical scenarios where excision can be considered and even recommended. In the appropriate patient population, isolated carpal excision can alleviate pain and improve mobility. Excisions of the pisiform, trapezium, and trapezoid have abundant literature evidence to support positive long-term functional outcomes.
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