Hamate fracture

Revision as of 04:49, 18 September 2019 by Rossdonaldson1 (talk | contribs) (Management)
(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)

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