Carpal coalition the fifth to eighth weeks. The lunate and triquetral bones are the most common carpal bones to fuse together, resulting in a lunotriquetral coalition in 1% of people. 60% of patients with a lunotriquetral coalition will have it bilaterally. Among isolated incidents the capitate and hamate bones are the next most common to fuse followed by the pisiform-triquetrum, trapezium-trapezoid, scaphoid-capitate, and triquetrum-hamate. Carpal coalitions may further be divided into four subtypes: Generally since carpal-carpal fusions do not cause unease or discomfort for the patient, and do not impair wrist function, treatment is not needed. However, in the minority of cases
Hamate bone bone has six surfaces: The "hook of hamate" () is found at the proximal, ulnar side of the hamate bone. The hook is a curved, hook-like process that projects 1–2 mm distally and radially. The hook forms the ulnar border of the carpal tunnel, and the radial border for Guyon's canal. Numerous structures attach to it, including ligaments from the pisiform, the transverse carpal ligament, and the tendon of Flexor carpi ulnaris. Its medial surface to the flexor digiti minimi brevis and opponens digiti minimi; its lateral side is grooved for the passage of the flexor tendons into the palm