Fracture of the hamate hook

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Traumatology

Background:

• Hamulus fractures are uncommon injuries.
• Diagnosis can be challenging, often relying on clinical presentation.
• Associated symptoms may include ulnar nerve involvement and carpal tunnel syndrome.

Purpose of the Study:

• To present a series of hamulus fracture cases.
• To evaluate diagnostic methods and treatment outcomes.
• To identify factors influencing treatment success.

Main Methods:

• Retrospective review of 21 hamulus fracture cases.
• Clinical assessment including pain, grip strength, and neurological status.
• Radiographic evaluation, including lateral trispiral tomography.
• Surgical intervention (excision) and non-operative management (immobilization).

Main Results:

• Pain on grasp, grip weakness, and dorsal wrist pain were common symptoms.
• Ulnar nerve paresthesia and mild carpal tunnel syndrome were frequently observed.
• Lateral trispiral tomography was superior for diagnosis.
• Surgical excision yielded excellent results, particularly in athletic individuals without associated injuries.
• Non-operative management with immobilization may be effective for acute fractures.
• Tenosynovitis, tendon fraying, or rupture occurred in 25% of cases.

Conclusions:

• Clinical evaluation is crucial for diagnosing hamulus fractures.
• Lateral trispiral tomography is the preferred imaging modality.
• Surgical excision is an effective treatment, with outcomes influenced by injury type and associated trauma.
• Non-operative management should be considered for acute fractures.