Hamate fracture: Difference between revisions

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==Management==
==Management==
*Hamate hook fracture
{{General Fracture Management}}
**Compression dresing or [[Forearm volar splint]]
 
**Nonunion is common and excision of bone may be necessary
===Hamate hook fracture===
*Hamate body fracture
*Compression dresing or [[Forearm volar splint]]
**Stable: [[Forearm volar splint]] immobilization
*Nonunion is common and excision of bone may be necessary
**Unstable (displaced, Guyon canal injury): splint immobilization and ortho referral
 
===Hamate body fracture===
*Stable: [[Forearm volar splint]] immobilization
*Unstable (displaced, Guyon canal injury): splint immobilization and ortho referral


==Disposition==
==Disposition==

Latest revision as of 04:49, 18 September 2019

Background

  • Must exclude injury to ulnar nerve/artery (hamate forms part of Guyon canal)
  • May involve the body, hook, or articular surface
    • Hook (common) - associated with interrupted swing of club, bat, or racquet (handle impacts hypothenar eminence)
    • Body (rare) - associated with fracture-dislocations of 4th/5th metacarpals

Clinical Features

  • Localized tenderness over hamate (elicited by compresing hypothenar eminence)

Differential Diagnosis

Carpal fractures

AP view

Evaluation

  • Standard and carpal tunnel views should be obtained
  • CT may be needed to identify occult fracture
Hamate fracture

Management

General Fracture Management

Hamate hook fracture

  • Compression dresing or Forearm volar splint
  • Nonunion is common and excision of bone may be necessary

Hamate body fracture

  • Stable: Forearm volar splint immobilization
  • Unstable (displaced, Guyon canal injury): splint immobilization and ortho referral

Disposition

See Also

References