Darstellung von Os hamatum-Frakturen im konventionellen Röntgenbild und CT: Experimentelle Ergebnisse sowie klinische Erfahrungen

Abstract

For the diagnosis of fractures of the body and hook of the hamate HR-CT is the imaging procedure of choice, in which case an axial or sagittal plane should be chosen.

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

“…Hook fractures were not discussed and included within this paper. Body fractures at all, are less frequent [ 19 ], [ 24 ]. This kind of fracture group consists of different entities with variant therapeutic considerations.…”

“…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 ].…”

“…The diagnostic is intricate because of few clinical findings and often inconclusive initial x-ray observances [ 2 ], [ 5 ], [ 6 ], [ 7 ], [ 8 ], [ 9 ], [ 10 ], [ 11 ], [ 14 ], [ 16 ], [ 19 ], [ 20 ], [ 23 ], [ 24 ], [ 25 ], [ 26 ].…”

Aktuelle Behandlung der Hamulus ossis hamati-Fraktur

“…Norman [14,31,33]. Selbst bei Kombination von drei Projektionen (dorsopalmar, lateral, Karpaltunnelaufnahme) werden in vitro und in vivo 40 -50 % der Frakturen übersehen [3,4]. Andresen und Mitarb.…”

“…Die Beurteilung der Aufnahmen kann durch seltene Normvarianten des Hamulus ossis hamati wie Hypo-und Aplasie, das Os hamuli proprium, sowie intraossäre Ganglien oder Zysten erschwert werden [8,44]. In vielen Fällen gelingt ein sicherer Frakturnachweis nur mithilfe von Schnittbildverfahren wie der Computertomographie (CT) [3 -6,19] und Magnetresonanztomographie (MRT) [3,5,6,46].…”