ABSTRACT
Objective: To explore the effectiveness of hollow screw for the treatment of basilar part fracture of hamate hook. Methods: Five patients with basilar part fracture of hamate hook, aged 24-47 years (mean, 31 years) were treated with open reduction and hollow screw fixation between June 2015 and February 2019. There were 4 males and 1 female. The causes of injury were athletic injury in 3 cases, falling injury in 1 case, and crushing injury in 1 case. Among them, 1 case was combined with sensory disturbance of one and a half fingers on the ulnar side of the palm. The grip strength of the affected side was significantly decreased when compared with that of the healthy side in all patients. The intervals between injury and surgery were 3-8 days (mean, 4.2 days). Postoperative follow-up was conducted regularly to measure the grip strength of the affected and healthy fingers and the total motion of ring and little fingers of the affected side. Darrow criteria was used to evaluate the effectiveness. Results: All the incisions healed by primary intention. All the patients were followed up 6-32 months (mean, 16 months). X-ray films showed that the basilar part fracture of hamate hook reached bony union, and the healing time was 2.0-3.5 months (mean, 2.2 months). At last follow-up, the grip strength of the affected side was (35.80±3.76) kg, showing no significant difference when compared with healthy side [(36.00±4.94) kg] ( t=0.094, P=0.930); and the total motion of ring and little fingers of the affected side was (529.0±8.9)°, which was significantly different from that before operation [(232.0±34.7)°] ( t=18.108, P=0.000). In 1 patient with ulnar nerve injury, the two-point discrimination of the innervation area was 4 mm, and the pain sensation and temperature sensation returned to normal. Assessed by Darrow criteria, the results were excellent in 4 cases and good in 1 case. Conclusion: For the basilar part fracture of hamate hook, hollow screw fixation can obtain secure reduction and fixation and provide sustained compression and counter-rotation for the broken end of fracture, thus allowing early joint motion and promoting fracture healing and recovery of wrist function. It is a relatively good method for the treatment of basilar part fracture of hamate hook.
ABSTRACT
PURPOSE: To evaluate the treatment results of fragment excision of the hamate hook nonunion. MATERIALS AND METHODS: Nine patients operated for hamate hook nonunion were reviewed retrospectively, and were clinically assessed for pain, range of motion, tingling sensation, and grip strength postoperatively. RESULTS: The initial symptoms were pain (3 cases), tingling sensation (3 cases), 5th DIP joint flexion LOM (2 cases), and pain and accompanying LOM in 5th DIP joint flexion (1 case). The causes of injuries seemed to be mainly associated with sports activities. Time from initial symptom to diagnosis was averaged 15 months (2 months-5 years), and confirmative image was plain x-ray (one case), carpal tunnel view (six cases), and CT scan (two cases). All patients underwent fragment excision, and in three patients with accompanying carpal tunnel syndrome, transverse carpal ligament release was performed accordingly. In three other patients complicated with 5th FDP rupture, tenorrhaphy was performed in two cases, and tendon transfer was performed in the other case. Eight patients showed excellent clinical results one year postoperatively, but one patient complained of transient tingling sensation on the 4th and 5th fingers. CONCLUSION: Hamate hook excision after nonunion showed excellent clinical results in one year postoperative follow-up.