Hamate fracture: Difference between revisions
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*Standard and carpal tunnel views should be obtained | *Standard and carpal tunnel views should be obtained | ||
*CT may be needed to identify occult fx | *CT may be needed to identify occult fx | ||
==Differential Diagnosis== | |||
{{Carpal fractures}} | |||
==Management== | ==Management== | ||
Revision as of 22:40, 17 November 2014
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 Fx
- Compression dresing or splint
- Nonunion is common and excision of bone may be necessary
- Body Fx
- Stable: splint immobilization
- Unstable (displaced, Guyon canal injury): splint immobilization and ortho referral
Images
See Also
Source
- Tintinalli