Abstract
Metacarpal hamate fractures and dislocations comprise a wide range of rare, complex
injuries. Their most common cause is hitting solid objects with the fist or sustaining
high-energy traumas. The clinical picture consists of pain and swelling in the proximal
ulnar side of the hand. Imaging, especially posteroanterior, oblique (30 and 60 degrees),
and lateral radiographs, reveals fractures and dislocations, providing a definite
diagnosis. Ideally, a computed tomography scan should complement imaging. Treatment
is often surgical. Fixation may be percutaneous for optimal closed reduction, but
with a low threshold for open reduction using Kirschner wires, screws, or plates to
reduce the risk of malunion, post-traumatic osteoarthritis, and chronic pain. We present
four patients with an average follow-up of 38 months who underwent surgical treatment
in the same medical center, with excellent functional outcomes and mean Disabilities
of the Arm, Shoulder, and Hand (DASH) score of 9 points. We also synthesized the available
evidence to guide the management of a low-frequency injury with significant prognostic
implications.
Keywords
metacarpal hamate fracture dislocation - fourth and fifth carpometacarpal - hamate
fracture
