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Lessons to be learned from a missed case of Hamate fracture: a case report
Vishal H Borse1, James Hahnel, Adnan Faraj
1Vishal Borse, Room 346, Institute of Medical & Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, LS2 9JT, UK. drjhahnel@hotmail.co.uk.
Introduction:
We report the case of a missed fracture through the body of the hamate bone, only detected on a later, mistakenly taken 30° oblique x-ray view. This case highlights some of the problems encountered with traditional x-ray views, and the need to consider oblique views as either standard procedure or as an adjunct where clinical suspicion remains high even in the presence of normal x-rays.
Case Presentation:
A healthy 26-year-old Caucasian male fell whilst jogging, suffering a low velocity injury to his right hand. Initial accident and emergency examination and x-rays failed to demonstrate a fracture. At clinic, anteroposterior and carpal tunnel radiographs showed no fracture, however a mistakenly taken oblique x-ray revealed a displaced hamate body fracture.
Conclusion:
The authors believe that where a hamate fracture is suspected, an oblique x-ray view should be considered as part of the initial diagnostic investigations. Furthermore an oblique x-ray view is of particular use when clinical suspicion for hamate fracture remains high in the light of otherwise normal x-rays.
