Extensive Carpal Anomalies

A:

Shows typical carpus in radial hemimelia (absence of radial side of forearm and hand). The radius, scaphoid, trapezium, first metacarpal, and thumb are absent. The ulna (U), lunate (L), triquetrum (T^Q), pisiforme (P), trapizoid (T^D), capitate (C), hamate (H), and second to fifth metacarpals and fingers are present. Note the radial deviation of the hand (manus vara).

B:

Ulnar dimelia (duplication of ulnar side of limb), type I, with double radial hemimelia (neither ulna has a radius), and single index finger. Note that the same bones are absent as in the preceding case, but that the bones present in the preceding case are duplicated here and are in mirror-image formation.

C:

Ulnar dimelia, type II, with double radial hemimelia, as above, and duplication of the index finger.

Redrawn from and used by permission of O'Rahilly, R. A survey of carpal and tarsal anomalies. J. Bone joint Surg. [Am.]35:626-642, 1953.

A:

Scheme of accessory carpal ossicles. Palmar aspect of the right hand; the more dorsally situated ossicles are shown in a given region of the hand can be determined; the descriptions of these ossicles provided in O'Rahilly's text may then be used as a guide in the differential diagnosis of a given case.

B:

Scheme of right carpus, anterior aspect, showing some recent cases of carpal coherence. The name of the author reporting the case and the date of publication are placed across the fused bones in each case.

Redrawn from and used by permission of O'Rahilly, R. A survey of carpal and tarsal anomalies. J. Bone joint Surg. [Am.]35:626-642, 1953.