Subscribe to RSS
DOI: 10.1055/s-0041-1741322
Percutaneous Dorsal Approach for Fractures of the Hook of the Hamate: A Less Common but Effective Option
Article in several languages: English | español Funding This research has not received specific aid from public agencies, commercial or non-profit entities.
Abstract
Introduction Hook of hamate fractures are rare. The best treatment option is a source of debate; it ranges from conservative to surgical techniques, including resection of the hook or a volar approach followed by internal fixation. These techniques are not exempt from risk. Minimal invasive fixation using a dorsal percutaneous approach and a headless, cannulated mini screw is another option, although not commonly considered. We present a case series of patients who underwent this surgical technique.
Methods This is a retrospective review of four patients with nondisplaced hook of hamate fractures treated with dorsal percutaneous fixation. The evaluation included symptoms, physical examination, and radiological (radiographs, magnetic resonance imaging [MRI], and computed tomography [CT]) findings, as well as pre and postoperative strength (determined with a Jamar (JLW Instruments, Chicago, USA) hydraulic dynamometer) and quick disabilities of the arm, shoulder and hand (QuickDASH) scores.
Results The union rate was 100% with no associated complications. All patients resumed their preinjury activities 3 months after the surgery and reported they would undergo surgery again if needed.
Conclusion This retrospective study shows that safe treatment of nondisplaced hook of hamate fractures with percutaneous dorsal fixation is feasible, with excellent clinical outcomes. In any case, our sample is limited, and further studies are required.
Data Confidentiality
The authors declare that they have followed the protocols of their work center on the publication of patient data. All patients complied with their inclusion in this study, signing the corresponding informed consent form.
Publication History
Received: 17 June 2020
Accepted: 25 March 2021
Article published online:
13 December 2021
© 2021. SECMA Foundation. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
References
- 1 Scheufler O, Radmer S, Erdmann D, Germann G, Pierer G, Andresen R. Therapeutic alternatives in nonunion of hamate hook fractures: personal experience in 8 patients and review of literature. Ann Plast Surg 2005; 55 (02) 149-154
- 2 David TS, Zemel NP, Mathews PV. Symptomatic, partial union of the hook of the hamate fracture in athletes. Am J Sports Med 2003; 31 (01) 106-111
- 3 Sarabia Condés JM, Ibañez Martínez L, Sánchez Carrasco MA, Carrillo Julia FJ, Salmerón Martínez EL. Hamate fractures. Rev Esp Cir Ortop Traumatol 2015; 59 (05) 299-306
- 4 Bansal A, Carlan D, Moley J, Goodson H, Goldfarb CA. Return to Play and Complications After Hook of the Hamate Fracture Surgery. J Hand Surg Am 2017; 42 (10) 803-809
-
5
Mouzopoulos G,
Vlachos C,
Karantzalis L,
Vlachos K.
Fractures of hamate: a clinical overview. Musculoskelet Surg. 2019 Apr;103(1):15-21. doi: 10.1007/s12306-018-0543-y. Epub 2018 May 29. PMID: 29845407
- 6 Bishop AT, Beckenbaugh RD. Fracture of the hamate hook. J Hand Surg Am 1988; 13 (01) 135-139
- 7 Cecava ND, Finn MF, Mansfield LT. Subtle radiographic signs of hamate body fracture: a diagnosis not to miss in the emergency department. Emerg Radiol 2017; 24 (06) 689-695
- 8 Kadar A, Bishop AT, Suchyta MA, Moran SL. Diagnosis and management of hook of hamate fractures. J Hand Surg Eur Vol 2018; 43 (05) 539-545
- 9 Failla JM. Hook of hamate vascularity: vulnerability to osteonecrosis and nonunion. J Hand Surg Am 1993; 18 (06) 1075-1079
- 10 Hirano K, Inoue G. Classification and treatment of hamate fractures. Hand Surg 2005; 10 (2-3): 151-157
- 11 Tolat AR, Humphrey JA, McGovern PD, Compson J. Surgical excision of ununited hook of hamate fractures via the carpal tunnel approach. Injury 2014; 45 (10) 1554-1556
- 12 Scheufler O, Radmer S, Andresen R. Dorsal percutaneous cannulated mini-screw fixation for fractures of the hamate hook. Hand Surg 2012; 17 (02) 287-293
- 13 Nanno M, Sawaizumi T, Ito H. Simplified dorsal approach to fracture of the hamate hook with percutaneous fixation with screws. J Plast Surg Hand Surg 2010; 44 (4-5): 214-218
- 14 Bachoura A, Wroblewski A, Jacoby SM, Osterman AL, Culp RW. Hook of hamate fractures in competitive baseball players. Hand (N Y) 2013; 8 (03) 302-307
- 15 Wright TW, Moser MW, Sahajpal DT. Hook of hamate pull test. J Hand Surg Am 2010; 35 (11) 1887-1889
- 16 Klausmeyer MA, Mudgal CS. Hook of hamate fractures. J Hand Surg Am 2013; 38 (12) 2457-2460 , quiz 2460
- 17 Carroll RE, Lakin JF. Fracture of the hook of the hamate: acute treatment. J Trauma 1993; 34 (06) 803-805
- 18 Demirkan F, Calandruccio JH, Diangelo D. Biomechanical evaluation of flexor tendon function after hamate hook excision. J Hand Surg Am 2003; 28 (01) 138-143
- 19 Watson HK, Rogers WD. Nonunion of the hook of the hamate: an argument for bone grafting the nonunion. J Hand Surg Am 1989; 14 (03) 486-490