Arch Hand Microsurg.  2017 Dec;22(4):273-279. 10.12790/ahm.2017.22.4.273.

Internal Fixation of Hamate Hook Fracture by Dorsal Percutaneous Headless Compression Screw and Cortical Screw: A Technical Note

• Kang SK
• Oh JR

• KMID: 2406132
• DOI: http://doi.org/10.12790/ahm.2017.22.4.273

Abstract

Hamate bone fracture is an uncommon injury, accounting for 2% of all carpal bone fractures. The common treatment of choice for hamate bone fractures is conservative treatment or excision of the hamate fracture fragment. We devised a new procedure that utilizes dorsal percutaneous compression screws for internal fixation. This technique was performed on two patients with left hamate hook base fractures. Tolerable active joint movement of the left wrist and fingers was permitted the first day post-surgery. Radiographs were taken after surgery, at 3 months, and at 6 months to determine the degree of union. No remarkable ligament injuries or nerve injuries were observed. This technique proved to be a relatively simple procedure when compared to the existing procedure while enabling early wrist movement. By preserving soft tissue, this procedure maintained blood supply decreasing risks of non-union. These advantages make this technique a recommendable new procedure for hamate hook fractures.

Keyword

Wrist; Carpal bones; Hamate bone; Minimal invasive surgery; Fracture fixation, internal

MeSH Terms

Carpal Bones
Fingers
Fracture Fixation, Internal
Hamate Bone
Humans
Joints
Ligaments
Wrist

Figure

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  Fig. 1 A 39-year-old woman. Preoperative plain radiographs of left wrist. Anteroposterior and lateral radiographs and computed tomography axial view shows that hamate bone hook fracture.

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  Fig. 2 Intraoperative photographs shows positioning of the hook area of hamate bone in to a round circle from the dorsal approach utilizing the C-arm guide pin insertion through the center of the hamate bone hook after previous positioning.

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  Fig. 3 Postoperative radiograph 4 months post-surgery.

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  Fig. 4 Postoperative computed tomography 6 months post-surgery.

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  Fig. 5 A 45-year-old man. Preoperative plain radiographs of left wrist. (A) Anteroposterior and lateral radiographs show scaphoid and hamate bone fracture. (B) Computed tomography axial view shows that scaphoid and hamate bone hook fracture.

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  Fig. 6 Postoperative radiography and postoperative radiography 3 months post-surgery (closed reduction and percutanous compression screw insertion of a scaphoid and hamate hook fracture).

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  Fig. 7 Postoperative computed tomography 6 months post-surgery.

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