An unusual hamate fracture

Thomas, Abey; Kelleher, John C.

doi:10.1097/00006534-198508000-00085

Cited by 5 publications

(9 citation statements)

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“…7 Inadequately treated hamate body fractures with CMC dislocations can result in nonunion and resultant disability. 16,17 Similar to most displaced articular fractures in other locations, appropriate diagnosis and ORIF of the hamate body fractures involving the CMC articular surface are important to achieve optimal outcomes from this injury. In our series, we present our experience with this injury pattern, including the clinical presentation, radiographic analysis, surgical technique, and clinical outcomes in six patients.…”

Section: Discussionmentioning

confidence: 99%

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Carpometacarpal 4/5 Fracture Dislocations: Fracture Morphology and Surgical Treatment

Verhiel

Knaus

Simeone

et al. 2020

Journal of Hand and Microsurgery

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We conducted a retrospective review of six patients with carpometacarpal (CMC) ⅘ fracture-dislocations managed with ORIF by a single surgeon between October 2006 and August 2017. An open, dorsal approach to the hamate was used with a combination of interfragmentary screw fixation and Kirschner wire reduction in the CMC joints. At a mean of 96 days follow-up (range: 31–265), all patients had recovered wrist motion, excellent grip strength, and complete resolution of pain. There were no complications or reoperations during the postoperative period. Radiographic review showed restoration of anatomy and well-maintained congruity of the CMC joints. Our study has shown favorable outcomes after open reduction and internal fixation of the hamate body fracture with interfragmentary screws, when combined with stabilization of the CMC dislocation with percutaneous Kirschner wires. Fracture morphology does not appear to guide choice for specific hardware (size screw, headed/headless) or use of a washer. This is a level IV, therapeutic study.

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Section: Discussionmentioning

confidence: 99%

“…Delays in diagnosis have been associated with worse outcomes in other studies. 16,17 Hamate body fractures represent a spectrum of morphologies that can involve the fourth and fifth CMC joints. Terminology in the literature aims to be descriptive but can vary widely between reports.…”

Section: Discussionmentioning

confidence: 99%

Carpometacarpal 4/5 Fracture Dislocations: Fracture Morphology and Surgical Treatment

Verhiel

Knaus

Simeone

et al. 2020

Journal of Hand and Microsurgery

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“…Other mechanisms of trauma are less frequent. Mainly, the fracture occurs after a transmission of forces along the fourth metacarpal (MC) axis [ 1 ], [ 5 ], [ 6 ], [ 7 ], [ 10 ], [ 11 ], [ 12 ], [ 14 ], [ 15 ], [ 20 ], [ 21 ], [ 24 ], [ 35 ], [ 36 ], [ 37 ], [ 42 ]. In a radial-deviated and about ten degree flexed fist, the distal part of the fourth MC bone stands upon the other anatomical structures and is the main point for loading the forces in a situation of falling or punching [ 11 ], [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Hamate’s coronal fracture: diagnostic and therapeutic approaches based on a long-term follow-up

Eder

Scheller

Schwab

et al. 2019

GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW; 8:Doc05

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“…Loth and McMillan (6) also described a coronal hamate fracture caused by the impact of an object on the dorsum of the hand. Coronal fractures of the hamate may be missed (4)(5)(6)(7)(8). This is because not all fractures are apparent from routine x-ray views of the wrist.…”

Section: Discussionmentioning

confidence: 99%

“…As well, infrequency of the injury and the absence of obvious clinical findings such as crepitus, deformity and massive swelling contribute to the difficulty in detection. As such, diagnosis has been delayed as long as three months postinjury in some cases (4). It has been suggested that when a boxer's fracture is not found after a significant punching injury, fracture of the hamate should be suspected (3).…”

Section: Discussionmentioning

confidence: 99%

Coronal fractures of the body of the hamate: Two case reports

Binhammer¹,

Rao²

1998

CAN J PLAST SURG

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Fractures of the hamate were classified by Milch (1) into body fractures and hook fractures; fractures of the body of the hamate were subdivided into those occurring on the radial side and those occurring on the ulnar side of the hook. Bowen (2) presented a hamate fracture in the coronal plane and, therefore, added a third category -fractures to the body of the hamate. The two cases described in this report are examples of this rare type of fracture; both were associated with disarticulations at the base of the fourth and fifth metacarpals. Open reduction and internal fixation led to rapid recovery in terms of stabilization of the hamatometacarpal joint and restoration of hand function. CASE PRESENTATIONS Case 1A 29-year-old, right-hand dominant woman was referred five days after punching a steel door with her closed right fist. She was seen by physicians at the emergency department of a local hospital, where she was placed in a fibreglass splint after reduction of the fifth metacarpal.Follow-up physical examination revealed minimal to moderate swelling and ecchymosis over the base of her right fifth metacarpal. X-rays revealed a hamate intra-articular fracture with the fifth carpometacarpal joint (Figure 1). Displacement was noted to be approximately 3 to 4 mm. An open reduction was recommended to reduce the dislocated fragment of the hamate, and eight days after the injury, the patient underwent open reduction and internal fixation.Maintenance reduction of the fifth metacarpal was achieved by two 1.1 mm Kirschner wires driven between the fourth and fifth metacarpals. The dislocated fragment of the hamate was positioned and fixed in place with a 0.7 mm Kirschner wire. Two 1.2 mm screws were then used with a plate over the fragment, and the 0.7 mm Kirschner wire was removed. The hand and wrist were immobilized by a volar plaster splint for three weeks, at which time it was replaced by a short-arm cast to immobilize the extremity for an additional three weeks. Six weeks after the operation, the Kirschner wires were removed (Figure 2). The patient returned to full activities by 12 weeks after surgery and was asymptomatic when seen at eight months postsurgery.Can J Plast Surg Vol 6 No 2 Summer 1998 81 CASE REPORTCorrespondence: Dr PA Binhammer, Sunnybrook Health Science Centre, H-210, 2075 Bayview Avenue, North York, Ontario M4N 3M5. Telephone 416-480-6731, fax 416-480-6800, e- Coronal fracture of the body of the hamate with associated dorsal dislocation at the bases of the fourth and fifth metacarpals is rare. Two cases of this injury, treated with open reduction and internal fixation, are reported. As well, other reports of coronal hamate fractures are reviewed.

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An unusual hamate fracture

Cited by 5 publications

References 0 publications

Carpometacarpal 4/5 Fracture Dislocations: Fracture Morphology and Surgical Treatment

Carpometacarpal 4/5 Fracture Dislocations: Fracture Morphology and Surgical Treatment

Hamate’s coronal fracture: diagnostic and therapeutic approaches based on a long-term follow-up

Coronal fractures of the body of the hamate: Two case reports

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