Bipartite Scaphoid Research Articles

Three-Dimensional Comparative Study of Human Bipartite Scaphoids and the Os Centrale of the Wrist in Neandertals and Non-Human Anthropoid Primates.

In humans, bipartite scaphoid still does not differentiate clearly from traumatic non-union of the scaphoid. To aid diagnosis, we sought to analyze the main geometrical similarities among bipartite scaphoids from primate species with fused and unfused scaphoid centrales. Four human embryos, four cases of adult humans with bipartite scaphoid, twelve adult specimens of other extant anthropoid primates, and two Neandertal scaphoid specimens were included in this study. Three-dimensional polygon models of the scaphoid and os centrale were generated from CT scan, micro-CT scan, or histological sections. A 3D comparative study of the morphological and morphometrical parameters was performed using the MSC Patran software. The os centrale was smaller than the scaphoid in all specimens and its shape was elongated in the anteroposterior scaphoid direction. The position of the os centrale centroid compared to the scaphoid using direction vectors had a strong orientation along the proximodistal axis in all species. The main morphological feature of bipartite scaphoid was the continuity of the scaphoid from its proximal pole to its tubercule along the anteroposterior axis. In all specimens, if the os centrale was removed, the scaphoid still appeared normal and whole. The bipartite scaphoid in adult humans shares geometrical analogies with monkeys and orangutans, human embryos, and Neandertals. Morphological and morphometrical features identified in this study are useful to differentiate bipartite scaphoid from scaphoid pseudarthrosis. All other criteria suggested in the past lead to misdiagnosis.

Three-dimensional CT for the diagnosis and management of bipartite scaphoids: a report of four cases in three patients

We investigated the role of three-dimensional (3-D) CT in the diagnosis and management of four bipartite scaphoids in three patients. We computed the volume ratio, moment of inertia ratio and direction vector from the centroid of the scaphoid to the os centrale carpi. We found that the os centrale carpi was always smaller than the scaphoid and showed an elongated shape in the scaphoid longitudinal axis. Its position was always posterior compared with the scaphoid anteroposterior axis. The main morphological feature of bipartite scaphoids was the continuity of the scaphoid from its proximal to distal aspect along the longitudinal axis. These criteria from 3-D imaging should be considered useful in the diagnosis of bipartite scaphoid as it allows differentiation from nonunion. 3-D single-photon emission computed tomography (SPECT)/CT was helpful in the surgical decision-making when the patient was symptomatic. 3-D imaging was also used for the preoperative simulation and planning of bone fusion as it simplifies surgery and makes it more accurate. Here we provide clear criteria for diagnosing bipartite scaphoids and for the planning when surgery is deemed necessary.

Skeletal Anomalies in The Neandertal Family of El Sidr\xf3n (Spain) Support A Role of Inbreeding in Neandertal Extinction

Neandertals disappeared from the fossil record around 40,000 bp, after a demographic history of small and isolated groups with high but variable levels of inbreeding, and episodes of interbreeding with other Paleolithic hominins. It is reasonable to expect that high levels of endogamy could be expressed in the skeleton of at least some Neandertal groups. Genetic studies indicate that the 13 individuals from the site of El Sidrón, Spain, dated around 49,000 bp, constituted a closely related kin group, making these Neandertals an appropriate case study for the observation of skeletal signs of inbreeding. We present the complete study of the 1674 identified skeletal specimens from El Sidrón. Altogether, 17 congenital anomalies were observed (narrowing of the internal nasal fossa, retained deciduous canine, clefts of the first cervical vertebra, unilateral hypoplasia of the second cervical vertebra, clefting of the twelfth thoracic vertebra, diminutive thoracic or lumbar rib, os centrale carpi and bipartite scaphoid, tripartite patella, left foot anomaly and cuboid-navicular coalition), with at least four individuals presenting congenital conditions (clefts of the first cervical vertebra). At 49,000 years ago, the Neandertals from El Sidrón, with genetic and skeletal evidence of inbreeding, could be representative of the beginning of the demographic collapse of this hominin phenotype.

New Neandertal wrist bones from El Sidrón, Spain (1994–2009)

Twenty-nine carpal bones of Homo neanderthalensis have been recovered from the site of El Sidrón (Asturias, Spain) during excavations between 1994 and 2009, alongside ∼2500 other Neandertal skeletal elements dated to ∼49,000 years ago. All bones of the wrist are represented, including adult scaphoids (n = 6), lunates (n = 2), triquetra (n = 4), pisiforms (n = 2), trapezia (n = 2), trapezoids (n = 5), capitates (n = 5), and hamates (n = 2), as well as one fragmentary and possibly juvenile scaphoid. Several of these carpals appear to belong to the complete right wrist of a single individual. Here we provide qualitative and quantitative morphological descriptions of these carpals, within a comparative context of other European and Near Eastern Neandertals, early and recent Homo sapiens, and other fossil hominins, including Homo antecessor, Homo naledi, and australopiths.Overall, the El Sidrón carpals show characteristics that typically distinguish Neandertals from H. sapiens, such as a relatively flat first metacarpal facet on the trapezium and a more laterally oriented second metacarpal facet on the capitate. However, there are some distinctive features of the El Sidrón carpals compared with most other Neandertals. For example, the tubercle of the trapezium is small with limited projection, while the scaphoid tubercle and hamate hamulus are among the largest seen in other Neandertals. Furthermore, three of the six adult scaphoids show a distinctive os-centrale portion, while another is a bipartite scaphoid with a truncated tubercle. The high frequency of rare carpal morphologies supports other evidence of a close genetic relationship among the Neandertals found at El Sidrón.

Six new examples of the bipartite trapezoid bone: Morphology, significant population variation, and an examination of pre-existing criteria to identify bipartition of individual carpal bones

Carpal bone bipartition is a developmental variant resulting in the division of a normally singular carpal into two distinct segments. Cases involving the scaphoid are best known, though many other carpals can be affected, including the trapezoid. Six new examples of bipartite trapezoids, identified in African and Asian anatomical and archeological samples, are reported here and compared with the eight previously known. While the site of bipartition is consistent, the resulting segments exhibit variability in their articulations with neighboring carpals. Five of the six affected trapezoids were identified in African or African-derived samples, yielding a significantly higher frequency (0.323%) of bipartite trapezoid than seen in anatomical or archeological series of European origin. Bilateral bipartite trapezoids in archeological remains from the Mid Holocene site of Gobero (Niger) are potentially the oldest bipartite carpals yet identified in humans. Their discovery may indicate that trapezoid bipartition is a condition that has been present in African populations since prehistoric times, though more data are needed. Because bipartite carpals may be symptomatic and can occur as part of syndromes, the significant population variation in frequency identified here has potential utility in both anatomical and clinical contexts. However, a comparison of the morphological appearance of bipartite trapezoids with the suggested criteria for bipartite scaphoid diagnosis indicates that these criteria are not equally applicable to other carpals. Fortunately, due to the rarity of fracture, identification of the bipartite trapezoid and separating it from pathological conditions is considerably easier than diagnosing a bipartite scaphoid.

Os scaphoideum bipartitum mit Osteonekrose des proximalen Anteils – Differenzialdiagnose zur Pseudarthrose

We report on the case of a young patient with bipartite carpal scaphoid with osteonecrosis of the proximal pole. The important differentiation of this entity to the pseudarthrosis of the scaphoid is discussed.

Bipartite os Centrale Carpi in a Patient with the First Metacarpal Bone Fracture

Bipartite os Centrale Carpi in a Patient with the First Metacarpal Bone Fracture

Fracture of the Proximal Pole of the Bipartite Carpal Scaphoid: A Probable Holt–Oram-Like Syndrome

Bipartite scaphoid has been debated, and is of a traumatic origin for some authors and congenital for others. The aim of study is to distinguish clinical, radiographic and MR criteria for the diagnosis of congenital bipartite scaphoid. I describe a case of a patient with bilateral bipartite scaphoid admitted at my clinic following a traumatic accident which produced a fracture of the proximal pole of the right carpal scaphoid. The patient had a history of bipartite scaphoid. In conclusion, I believe that congenital origin is more probable and this rare pathology is a sporadic form of Holt-Oram-like syndrome.

Pseudarthrose du scaphoïde carpien bilatérale ou scaphoïde carpien bipartite dégénéré ?

The authors report a case of bilateral division of the carpal scaphoid in a 36-year-old man. In the right wrist, all the clinical and radiological signs suggested a bipartite scaphoid, but in the left wrist the presence of pain and pan-radial osteoarthritis rather suggested a pseudarthrosis of the scaphoid. This raises the possibility of osteoarthritis occurring overtime in a bipartite carpal scaphoid.

Bilateral Bipartite Carpal Scaphoid: A Case Report

Bipartite scaphoid is a rare anomaly and it has been questioned as whether it is of congenital origin or traumatic. However, many authors have reported that congenital origin is more probable. There was no case report in Korea about bipartite scaphoid, but this article reports a case of a 38-year-old male with bilateral bipartite scaphoid.

BIPARTITE SCAPHOID WITH PROXIMAL POLE OSTEONECROSIS IN A PATIENT WITH HOLT-ORAM SYNDROME

The Holt-Oram syndrome features a spectrum of upper limb abnormalities, including an abnormal shape of the scaphoid. Our report concerns a 19-year-old man with Holt-Oram syndrome and flattening and sclerosis of the proximal pole of a bipartite scaphoid. The initial ossification centre in the scaphoid was located distally at 8 years of age. By age 13, a pair of ossific centres were present. After an automobile accident at age 18, the proximal pole became sclerotic and then began to fragment over a 22-month period. Computed tomography confirmed the presence of two poles of the scaphoid and sclerosis and fragmentation of the proximal pole.

Bilateral stress fracture of the scaphoid

Bilateral stress fractures of the scaphoid bones in a gymnast are reported and discussed with special consideration of the possible differential diagnoses; bipartite scaphoid and pseudarthrosis of the scaphoid bone. The relevance of the mechanical factors involved and the abduction and dorsiflexion of the wrist in gymnastics are suggested as likely pathomechanisms.

Congenital bipartite scaphoid

A case of bilateral congenital bipartite scaphoid followed from early ossification of the scaphoid to skeletal maturity is presented. Magnetic resonance imaging was shown to be helpful in differentiating this condition from traumatic pseudarthrosis of the scaphoid. The history of this rare anomaly is discussed.

Use of the Herbert bone screw for scaphoid nonunions.

The Herbert bone screw was used to treat 22 selected patients with established scaphoid nonunions. The indications for its use included evidence of avascular necrosis, proximal third fracture fragment, previous bone graft, fracture angulation or displacement, and a bipartite scaphoid. Treatment resulted in radiographic and clinical evidence of healing in 16 patients; 4 patients were symptom-free, but had incomplete healing as evidenced by radiograph; and 2 patients had persistent symptoms with radiographic evidence of nonunion.

Synostose bilatérale semilunaire-pyramidal avec fracture bilatérale des scaphoïdes

The authors have treated a case of bilateral fracture of the scaphoid bone in a young man who had complete and bilateral lunato-triquetral synostosis, without any other associated congenital condition. Consolidation was obtained by orthopedic treatment on one side, but a Matti-Russe operation was necessary on the other. The authors emphasize but then rule out the hypothesis of a congenital bipartite scaphoid associated with the synostosis. A review of the literature on lunato-triquetral synostoses sums up the main points. The condition is rare in whites and occurs more frequently in blacks. It is sometimes associated with other congenital conditions. Four anatomic and radiologic types have been described. The pathogenic hypotheses, based on embryology, are summarized.

The bipartite tarsal scaphoid.

Brailsford introduced the descriptive term “listhesis of the tarsal scaphoid” to describe the cinicopathological changes associated with congenital bipartition ofthis bone. This uncommon condition involves the separation and displacement oftwo scaphoid fragments, producing a fixed flat foot deformity, which eventually becomes symptomatic. Six cases are described, the lesion being bilateral in three. No particular definitive treatment is advocated, other than symptomatic management. Brailsford (1953) used the descriptive term “listhesis of the tarsal scaphoid” to describe an uncommon clinical entity associated with a flat foot. This lesion which is also called bipartite scaphoid was first described by Muller (1927, 1928) and was initially thought to be the end-result of childhood K#{246}hler’s disease. The lesion was eventually shown to be a distinct entity (Brailsford 1935; Zimmer 1937). After his initial report of five cases, Brailsford subsequently included some 20 cases of the lesion in his textbook (Brailsford 1953). The purpose of this paper is to reiterate the features of this entity and add a further six cases to the reported literature.

Congenital bipartite scaphoid--fact or fiction?

Whether there is such a condition as congenital bipartite scaphoid has long been debated. Five cases that fulfill the established criteria are presented, supplemented by a review of roentgenograms of 17,439 hands in which no case of bipartite scaphoid was detected. Serial sections of 196 fetal hands also failed to reveal any evidence of bipartite development of the scaphoid. We concluded that bipartite scaphoid is of traumatic origin and should be treated accordingly.