Page 19 - Delaware Medical Journal - March/April 2019
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CASE REPORT
reviewing the wrist radiographs of 1,000 children. Four of the patients had CH coalitions, two had LT coalitions, and one had a capitate-trapezoid coalition. Since then, little has been written on this topic. The aim of our study is to demonstrate the sequence of developing wrist carpal coalition, highlighting the time course and
MATERIALS AND METHODS
After Institutional Review Board approval, we queried our
seen at our tertiary-care pediatric hospital. Twelve patients (18
wrists) of the total 104 had sequential radiography demonstrating
different phases of the development of the coalition. Inclusion
criteria required each patient to have at least two radiographs of B the same CC at two different time points at least two months apart
interest. To maximize the number of patients, an anteroposterior radiograph of the wrist, hand, or forearm was accepted.
The exclusion criteria were a history of any fractures among the
carpal bones, history of any severe degenerative changes within C diagnosis of CC could not be made with certainty, or patients with
only two or more radiographs in which no noticeable change in the appearance of the carpal bones of interest could be detected.
A. LT coalition of the wrists of a boy, age 4y6m
B. LT coalition of the wrists of a boy, age 5y5m
C. LT coalition of the wrists of a boy, age 6y
D. LT coalition of the wrists of a boy, age 7y2m
E. LT coalition of the wrists of a boy, age 9y6m. LT, luno-triquetral
FIGURE 1
A
The chronological age at each radiograph was recorded. If the left-hand radiograph was unavailable, the skeletal age assessment was based on the right hand. In the case of forearm radiographs, the bone age was assessed only if the authors felt that the wrist rotation
Data were summarized using mean, standard deviation, frequency, and percentages.
RESULTS
children (three boys, one girl) with CH coalition comprised
the study group. Radiographs were obtained for a variety of clinical indications. For the eight patients with LT coalitions,
with CH coalitions, one had radiographs taken for clinical evaluation of short stature, one for the diagnostic evaluation of Leri-Weill dyschondrosis (Turner syndrome variant), another for
D
E
Del Med J | March/April 2019 | Vol. 91 | No. 2
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