Fracture of the body of hamate associated with a fracture of the base of fourth metacarpal: A case report and review of literature of the last 20 years

Abstract

After reviewing the literature, we conclude that there is a high rate of delay in the diagnosis of these lesions, probably due to their rarity and to the lack of radiological studies specifically targeting this region. Despite this, surgical treatment in its different modalities has been shown to have the best clinical and functional results.

A rare coronal fracture of the medial carpal column: Case report

“…Coronal hamate fractures are caused by axial trauma to the 4th and 5th rays of the hand with ulnar deviation and palmar flexion [4]. We hypothesized that our patient sustained axial trauma with slight ulnar deviation, which induced initial contact with the 3rd and 4th rays of the hand.…”

“…The full diagnosis is based on a complete clinical examination and standard X-rays. Posterior subluxation of the 4th and 5th metacarpals on the lateral view should lead one to suspect a capitate and/or hamate injury [4]. We think that additional X-rays with ulnar deviation or stress X-rays could be painful for the patient and that a CT scan could be more helpful.…”

“…Capitate fractures represent 0.2 to 1.3% of carpal fractures, hamate fractures 2 to 4% and triquetrum fracture 18 to 30% [4,[16][17][18][19]. A simultaneous coronal fracture of these three bones is extremely rare.…”

“…We think that additional X-rays with ulnar deviation or stress X-rays could be painful for the patient and that a CT scan could be more helpful. Indeed, a CT scan should be systematic if there is any doubt, to ensure that the fractures are not missed [3,4,[19][20][21][22]. The CT scan images can help to determine the type of lesion, detect fracture displacement, and provide information about potential associated ligament lesions.…”

“…Carpal coronal fractures are rare [1][2][3][4][5][6][7][8][9][10][11][12]. The first challenge is to recognize them and the second is to select the appropriate treatment.…”