Hamate fracture: Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "*Tintinalli" to "") |
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**Body: | **Body: | ||
***Rare | ***Rare | ||
***Assoc w/ | ***Assoc w/ fracture-dislocations of 4th/5th metacarpals | ||
==Clinical Features== | ==Clinical Features== | ||
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==Imaging== | ==Imaging== | ||
*Standard and carpal tunnel views should be obtained | *Standard and carpal tunnel views should be obtained | ||
*CT may be needed to identify occult | *CT may be needed to identify occult fracture | ||
[[File:Hamate_Fracture.jpg|thumb|Hamate fracture]] | [[File:Hamate_Fracture.jpg|thumb|Hamate fracture]] | ||
Revision as of 10:51, 8 July 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/ fracture-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 fracture
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