Primary carpal bone defect

We present a review of management options in case of carpal bone defect, a relatively frequent discovery. In the literature, diagnosis is usually a fortuitous radiographic finding s howing one or several images of carpal defect. Pain is observed in some cas es, more exceptionally pathological fracture. The scaphoid, lunatum and ham atum are most frequently involved. Bilateral defects may be observed. Different mechanisms have been put forward to explain the development of in traosseous defects in the carpal bones including intraosseous penetration o f synovial tissue, or in situ metaplasia of bone tissue. The main different ial diagnoses are osteonecrosis sequellae (for the lunatum and the scaphoid ), subchondral defects due to hyperpression and arthropathies in dialysis p atients. All authors propose simple surveillance for asymptomatic images. In case of pain, with soft tissue swelling or pathological fractures, filling-excisio n is warranted depending on the severity of the clinical signs. Prognosis i s generally good and recurrence exceptional.