Dislocation of the hamate associated with fracture of the trapezial ridge

Ohshio, Itaru; Ogino, Toshihiko; Miyake, Akira

doi:10.1016/s0363-5023(86)80007-7

Cited by 16 publications

(12 citation statements)

References 3 publications

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“…The location of this fracture was not specified. 19 In our study, treatment was not altered on discovery of concomitant ulnar carpal injuries; however, the case presented by Ohshio et al 14 required surgical intervention for treatment of the dislocated hamate with open reduction and Kirschner wire fixation. In this particular case, advanced imaging with computed tomography was used to better characterize the injury pattern.…”

Section: Discussionmentioning

confidence: 63%

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Trapezial Fractures and Associated Fractures of the Ulnar Carpus: A Ring-Bone Model

2023

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Background:Fractures of the trapezium are rare; however, the incidence may be under-reported in the literature. The incidence of ulnar-sided carpal body fractures as a concomitant injury has not been reported. Our study aimed to evaluate the incidence of trapezium fractures in conjunction with ulnar-sided carpal body fractures.Methods:Over a five-year period, our electronic records were queried and charts reporting carpal bone fractures were reviewed. All cases of trapezium fracture were evaluated further and presented.Results:Eight trapezial fractures were identified, representing 8% of all carpal fractures and 26% of all nonscaphoid carpal fractures. Of the eight trapezium fractures identified, five (62.5%) were associated with Bennett fracture and four (50%) were associated with ulnar-sided carpal fractures.Conclusion:Our study demonstrates a higher incidence of trapezial fractures than previously reported. Previously unreported concomitant ulnar-sided carpal body fractures are reported at a frequency nearly equal to that of concomitant Bennett fractures in our series. We propose a mechanism of injury where the carpal canal and overlying transverse carpal ligament function as a ring-bone construct similar to the pelvis. When a trapezium fracture is identified, we recommend additional evaluation for ulnar-sided injuries of the carpus.

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Section: Discussionmentioning

confidence: 63%

“…These have been associated with fracture avulsion of the trapezial ridge from forces applied through the transverse carpal ligament (TCL); however, the incidence of concomitant ulnar carpal body injury has not yet been reported. 11 12 13 14 15 …”

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confidence: 99%

Trapezial Fractures and Associated Fractures of the Ulnar Carpus: A Ring-Bone Model

2023

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“…4 ). Ohshio et al 2 suggested palmar traction forces on the hamate, through the insertion of transverse carpal ligament on its hook, when dorsal pressure is applied to the carpus. Flexion of the wrist and fingers would increase the pressure in carpal tunnel and thus the palmar traction on hamate.…”

Section: Discussionmentioning

confidence: 99%

“…The literature remains limited with regard to the evaluation of dislocations with or without fracture of the hamate with only 27 cases reported to date (23 cases from a literature review with four additional cases not included). 2,[4][5][6][7] The overwhelming majority of reports were of cases that occurred in the context of high-energy wrist trauma. Diagnosis was often delayed, with seven cases (26%) diagnosed between 2 days and 6 months after the causative trauma.…”

Section: Discussionmentioning

confidence: 99%

Palmar Dislocation Fracture of the Hamate: A Case Report and Review of Literature

et al. 2023

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Objective Hamate dislocations are rare lesions of the carpus, which make their diagnosis difficult or even missed, and their management non-standardized. Case Description We report the case of a 34-year-old victim of a high kinetic traffic accident. The initial evaluation revealed multiple fractures of both upper limbs, including a palmar fracture dislocation fracture of the hamate, without any vascular or nerve complications. Open surgical treatment via a dorsal approach allowed reduction and fixation of the hamate by temporary multiple pinning. At 12-month follow-up the patient had pain free motion of the wrist with a DASH score of 3. Radiographs showed evidence of proximal pole hamate sclerosis and carpo-metacarpal narrowing. Literature Review Owing to its rarity, literature on this topic is extremity limited. Various mechanisms have been described to explain these injuries, including dorsal pressure on the carpus associated with traction of the annular carpal ligament on its hamate insertion. Symptoms can be minimal and only three cases of nerve complications have been reported. Long-term outcomes following these injuries usually result in decrease in wrist motion and grip strength. Clinical Relevance The rarity of dislocations with or without hamate fracture favors the absence or the delay of diagnosis, which must lead to a precise radiographic analysis and to the implementation of a CT scan in case of high kinetics carpal trauma, even if it is poorly symptomatic. Level of Evidence Level 5, case study.

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“…The X-ray showed the wrist alignment was normal. According to the previous literature, dislocation of the hamate could be palmar or dorsal (Ohshio et al, 1986), but it is still unclear whether the mechanism of both injuries is the same. In our case, the machine prints on both the dorsal and palmar sides of the wrist gave us a clue to the mechanism of injury.…”

Section: Dislocation Of the Hamate And Its Possible Mechanismmentioning

confidence: 99%