Carpal Coalition in School-Aged Children in Moray, Scotland: A Retrospective Radiographic Case Series

Abstract Carpal coalition is a congenital fusion between carpal bones, most often identified incidentally during radiographic evaluation following trauma. This retrospective case series describes the proportion and radiographic characteristics of carpal coalition in school-aged children within a defined geographic region of Moray, Scotland. A review of all Hand and Wrist radiographs of children aged 6-18 years old was performed over 2 years (2021 and 2022), including trauma/emergency and elective clinics. A total of 498 radiographs were analysed, identifying 9 children with carpal coalition (proportion 1.8%). Hamate–capitate fusion was the most frequently observed pattern. All cases were incidental findings in children presenting with trauma and none were clinically symptomatic. While this series provides descriptive insight into carpal coalition within a local Scottish cohort, the findings are not generalisable due to selection bias and the small sample size. Future research could help better understand why our observed proportion is higher.