BACKGROUND AND PURPOSE:
Carpal synostoses are congenital defects characterized by complete or incomplete coalition of two or more carpal bones. Although most of these defects are discovered only incidentally, sometimes they become clinically manifest. Among the different types of carpal coalition, the synostosis between capitate and trapezoid bones is quite rare, with only sparse data available in the literature. The aim of this report was to describe a case of capitate-trapezoid synostosis observed in an ancient human skeleton, as well as to scrutinize the pertinent literature in order to assess for the characteristics of this type of defect, including its potential relevance to clinical practice.
METHODS:
We studied the skeletal remains of an Early Bronze Age male warrior affected by incomplete capitate-trapezoid synostosis. Macroscopical and radiological examination of the defect was carried out. We also performed a comprehensive PubMed search in the Medline and other specialty literature databases to retrieve and analyze data relevant to the subject under consideration.
RESULTS AND CONCLUSIONS:
The present case is the most ancient capitate-trapezoid synostosis ever found. In those literature-reported cases accompanied by careful anatomical description, such as the present one, incomplete coalition invariably occurs between the dorsal surfaces of the two bones, this characteristic emerging as a distinctive morphological trait. Literature analysis further suggests that the true prevalence of capitate-trapezoid synostosis is likely to be higher than estimates based on data gathered from radiology series, and that this defect may be associated with pain and carpal bossing more frequently than generally thought.
