Hamate fracture: Difference between revisions
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Revision as of 17:57, 26 June 2016
Background
- Must exclude injury to ulnar nerve/artery (forms part of Guyon canal)
- May involve the body, hook, or articular surface
- Hook:
- Common
- Assoc w/ interrupted swing w/ club, bat, or racquet (handle impacts hypothenar eminence)
- Body:
- Rare
- Assoc w/ fx-dislocations of 4th/5th metacarpals
- Hook:
Clinical Features
- Localized tenderness over hamate (elicited by compresing hypothenar eminence)
Imaging
- Standard and carpal tunnel views should be obtained
- CT may be needed to identify occult fx
Differential Diagnosis
Carpal fractures
- Scaphoid fracture
- Lunate fracture
- Triquetrum fracture
- Pisiform fracture
- Trapezium fracture
- Trapezoid fracture
- Capitate fracture
- Hamate fracture
Management
- Hamate Hook Fracture
- Compression dresing or Forearm volar splint
- Nonunion is common and excision of bone may be necessary
- Body Fracture
- Stable: Forearm volar splint immobilization
- Unstable (displaced, Guyon canal injury): splint immobilization and ortho referral