Grip strength after hamate hook excision and reconstruction surgery: A biomechanical cadaveric study

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanics

Background:

• Hamate hook fractures are prevalent in professional athletes.
• Surgical excision of the hamate hook is a common treatment.
• The impact of resection extent on grip strength requires further investigation.

Purpose of the Study:

• To quantify hand grip strength changes following hamate hook resection at varying degrees.
• To compare grip strength after different levels of hamate hook excision and perihamate ligament reconstruction.

Main Methods:

• Cadaveric forearm flexor digitorum profundus tendons were subjected to 5-15 kg forces.
• Grip strength was measured under five conditions: intact, one-third, two-thirds, and total hamate excision, and post-ligament reconstruction.
• Multilevel mixed-effect models analyzed scaling ratios compared to a normal hamate hook.

Main Results:

• Grip strength decreased by 25%, 36%, and 47% after one-third, two-thirds, and total hamate hook resection, respectively.
• Perihamate ligament reconstruction resulted in a 7% increase in grip strength (107% of baseline).
• A direct correlation exists between the extent of hamate hook resection and grip strength reduction.

Conclusions:

• The degree of hamate hook resection significantly impacts hand grip strength.
• Perihamate ligament reconstruction is a viable option to restore grip strength to pre-operative levels.