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Biomechanical evaluation of flexor tendon function after hamate hook excision
Fahir Demirkan1, James H Calandruccio, Denis Diangelo
1Department of Orthopaedic Surgery, Pamukkale University School of Medicine, Denizli, Turkey.
The Journal of Hand Surgery
|February 4, 2003
Summary
Excision of the hamate hook, a treatment for fractures, may decrease hand grip strength. This study found reduced flexor tendon force and altered tendon movement after hamate hook excision.
Area of Science:
- Orthopedic surgery
- Biomechanics
- Hand anatomy
Background:
- Hamate hook fractures are rare and their treatment, particularly hamate hook excision, remains debated.
- The biomechanical consequences of hamate hook excision on flexor tendon function are not well understood.
Purpose of the Study:
- To investigate the biomechanical effects of hamate hook excision on flexor tendon function.
- To determine if hamate hook excision impacts flexor tendon force, excursion, and shift.
Main Methods:
- Biomechanical analysis of fresh cadaveric forearm specimens.
- Wrist positioning in neutral, 30 degrees extension, and 30 degrees extension with 30 degrees ulnar deviation.
- Evaluation of flexor tendon force, excursion, and shift before and after hamate hook excision.
Main Results:
- A decrease in flexor tendon force was observed post-excision (11-15% across wrist positions).
- Increased proximal excursion of flexor profundus tendons (7-11 mm) occurred after excision.
- Ulnar shift of the flexor profundus tendons of the small finger was noted (4-5 mm).
Conclusions:
- The hamate hook contributes biomechanically to flexor tendon function.
- Hamate hook excision may lead to a reduction in power grip strength.
- These findings suggest potential functional deficits following hamate hook excision.