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Imaging of hamate bone fractures in conventional X-rays and high-resolution computed tomography. An in vitro study
R Andresen1, S Radmer, M Sparmann
1Department of Diagnostic Radiology and Nuclear Medicine, Behring Municipal Hospital, Free University of Berlin, Germany.
Rationale And Objectives:
To examine the ability to image fractures of the body and hook of the hamate bone in conventional X-rays and high-resolution computed tomography (HR-CT).
Materials And Methods:
In an in vitro experiment using 18 cadaver hands, the hamate bone was fractured at different places. Before and after fracture, conventional X-rays were taken in different planes (anteroposterior, lateral, oblique, and carpal tunnel), and HR-CT was performed with 2-mm layer thickness in the axial, sagittal, and coronal plane.
Results:
Taking into account all the conventional X-ray projections applied, the in vivo experiment revealed a sensitivity of 72.2%, a specificity of 88.8%, and an accuracy of 80.5%. For the HR-CT, the sensitivity was 100%, the specificity was 94.4%, and the accuracy was 97.2%.
Conclusions:
Fractures of the body and hook of the hamate cannot always be detected with certainty in the conventional X-ray image, even if different projectional planes are used. The HR-CT is the imaging procedure of choice for further clarification, and an axial or sagittal plane should be selected.