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J Wrist Surg 2014; 03(04): 269-274
DOI: 10.1055/s-0034-1394135
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Avascular Necrosis of the Hamate: Three Cases and Review of the Literature

Sebastian J. Peters
1   Orthopaedic Department, Hand Unit, University Hospitals Leuven, Pellenberg Campus, Pellenberg, Belgium
2   Orthopaedic department, Regional Hospital Heilig Hart Leuven, Leuven, Belgium
,
C. Verstappen
1   Orthopaedic Department, Hand Unit, University Hospitals Leuven, Pellenberg Campus, Pellenberg, Belgium
,
Ilse Degreef
1   Orthopaedic Department, Hand Unit, University Hospitals Leuven, Pellenberg Campus, Pellenberg, Belgium
,
Luc De Smet
1   Orthopaedic Department, Hand Unit, University Hospitals Leuven, Pellenberg Campus, Pellenberg, Belgium
› Author Affiliations
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Publication History

Publication Date:
24 October 2014 (online)

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Abstract

Background Avascular necrosis of the hamate (hamate-AVN) is a seldom reported disease of which little is known on etiology, best treatment modalities, and outcome. Hamate-AVN can occur in multiple locations within the hamate.

Case Description Case one was an 8-year-old girl with painful AVN of the hamate hook. Surgical excision of the hook was performed, leading to excellent results (follow-up 8 years). Case two was a 44-year-old man with hamate-AVN of the proximal pole surgically treated with a vascularized bone graft from the radius based on the fifth extensor compartment artery, leading to excellent results (follow-up 7 years). Case three was a 36-year-old woman with hamate-AVN of the proximal pole surgically treated with débridement and cancellous bone grafting, leading to poor results (follow-up 1 year).

Literature Review Nine other cases of avascular necrosis of the hamate were found in literature, all but one treated surgically. Etiology, treatment, and results of these cases, combined with our own cases, are reviewed.

Clinical Relevance This article summarizes and synthesizes all presented cases of avascular necrosis of the hamate. We hope this will be helpful to physicians in decision making when confronted with this rare entity.

Level of Evidence 4

Keywords

avascular - hamate - necrosis - osteonecrosis - treatment
 

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