Hamate fractures are rare and underreported. Hamate fractures can pose a diagnostic challenge for the treating physician 1. Hamate fractures are usually misdiagnosed or confused with simple wrist sprains. The rarity of hamate fracture as well as the complex anatomy of the carpal bones can make hamate fracture diagnosis commonly missed 2. The hamate bone is the bone most commonly fractured when a golfer hits the ground hard with a golf club on the downswing or a hockey player hits the ice with a slap shot. The fracture is usually a hairline fracture, commonly missed on normal X-rays.
Fracture of hamate The hamate bone is a bone that may be readily distinguished by its wedge-shaped form, and the hook-like process, which projects from its volar surface. It is situated at the at the medial and lower angle of the carpus, with its base downward, resting on the fourth and fifth metacarpal bones, and its apex directed upward and lateral ward. Scaphoid and Hook of Hamate Fractures. Scaphoid fractures most commonly occur as a result of a fall onto an outstretched hand. These fractures notoriously heal poorly and require quite significant immobilisation and rehabilitation following removal of the plaster cast. Surgical treatment of hamate fractures must always be an individualized therapeutic decision. However, surgical hamate fracture care is most frequently recommended when: Closed reduction fails or the simple splint or cast immobilization does not maintain the reduction.
What causes a hook of hamate fracture? A hook of hamate fracture in the wrist can occur from swinging a golf club, tennis racket or baseball bat, particularly if it suddenly hits an immovable object. For example if you swing a golf club hard and it strikes the floor instead of the ball. This patient struck a hard object with his fist. He presented with pain on wrist motion and tenderness at the base of his fifth metacarpal. Note on the PA radiograph that a lucent line through the ulnar surface of his hamate bone is visible. These fractures are managed with a forearm cast.
Fracture of the hook of hamate is often caused by swinging a baseball bat, tennis racket or golf club, especially when it suddenly hits a stationary object. Direct blow to the wrist. Fracture of hook of the hamate can also be a result of forceful muscular contractions though there may be no direct trauma. Introduction: A rare carpal fracture; Epidemiology. incidence < 2% of all carpal fractures; Pathophysiology. mechanism of injury. main cause for these lesions is a direct impact against a hard surface with a clenched fist. Hook of hamate fracture will present with pain over the hypothenar eminence, and may become painful if pressure is applied to dorso-ulnar aspect of the hand Gittlen, 1984. Fracture of the hook of hamate can lead to compression of the ulnar canal, either directly from bony fragments applying pressure to the nerve or indirectly from fracture associated bruising and swelling. Twenty-nine patients with hamate fractures were treated. The two main types of hamate fractures are hook fractures type 1 and body fractures type 2. We sub-divided type 2 fractures according to the fracture line into coronal, type 2a and transverse, type 2b. There were 15 type 1, 11 type 2a and three type 2b fractures.
Falling injuries can indirectly cause a hamate fracture through the surrounding muscles or ligaments, especially when hyperextending the wrist by landing flat on the palm. Some other wrist complaints can also lead to the condition. Complications of a Hamate Fracture The ulnar nerve frequently becomes compressed as a result of hamate fractures. 27/12/2014 · Twenty-nine patients with hamate fractures were treated. The two main types of hamate fractures are hook fractures type 1 and body fractures type 2. We sub-divided type 2 fractures according to the fracture line into coronal, type 2a and transverse, type 2b. There were 15 type 1, 11 type 2a and three type 2b fractures.
Hamate fractures are commonly divided into hook fractures and body fractures. The coronal fractures as a special form of hamate’s body fracture are very rare injuries. Because of unspecific clinical findings and the mostly inconclusive x-ray imaging, these fractures are frequently overseen or misdiagnosed. Hook of hamate fractures are rare. They occur from the hamate fracturing after blunt trauma, falls, and in sports player e.g. golf, baseball, racquet sports from a direct blow while swinging. Stress fractures have also been reported. It may r.
06/08/2018 · Although hamate fractures are increasing in incidence secondary to the popularity of sports activities involving racquets, bats, and clubs, these injuries remain relatively rare. Estimates suggest hamate fractures constitute 2% of all carpal fractures. Hamate. Hamate fracture involves the body or the hook. Fractures of the hook can occur as a result of impact with the handle of a racquet or club during ball strike or from a fall on the volar, ulnar aspect of the hand. 16. The clinical presentation is pain with palpation over the hook and painful grip. Type 2b transverse fractures of the body of the hamate are the “true” hamate fractures that will interfere with carpal biomechanics by breaking the carpal ring, and which need adequate stabilization. Isolated transverse fractures of the hamate are rare, but. If you have a hook of hamate fracture due to a recent injury, then your doctor may consider non-surgical treatment. Wearing a splint or cast for six to eight weeks has been shown to successfully heal most recent fractures. Hamate fractures are uncommon compared with scaphoid and distal radius fractures but, like these, often occur from a fall onto an outstretched hand. This topic will review fractures of the hamate in adults. An overview of carpal fractures and reviews of common wrist injuries in adults are presented separately.
Non-operative treatment typically consists of a short arm cast below the elbow or a hand based splint to protect the hamate bone see below. However, nonoperative treatment has a high failure rate. Surgical treatment of a hamate fracture includes removal of the broken piece, which generally has good results. Introduction. Hamate fractures mainly occur in two locations - the hook of the hamate or the body. Hook of the hamate fractures are common in sports with hand held equipment where a direct blow occurs to the palm of the hand - for instance a baseball bat, golf club. 08/12/2019 · Fractures of the hook of the hamate have rarely been reported. They have usually resulted from blunt trauma or a sharp strike against the hamate hook while swinging a golf club, baseball bat, or tennis racquet. Patients present with acute onset of pain localised over the ulnar aspect of the wrist and reduction in grip strength. In. Dr. Sheskier responded: 90-95% ok. Scaphoid fractures can go to non union not healed best result is with a thumb spica wrist cast. Hamate fractures usually heal without a problem. Physiotherapy is a very effective treatment for a fracture of the hook of hamate. What causes a fracture of the hook of hamate? The hook of hamate is commonly fractured following a direct impact to the bone in the palm of the hand. This can happen, for example, whilst playing hockey when your club hits the ground instead of the puck.
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