Hamate Body Fracture



Hamate Body Fracture


Kenrick C. Lam

Andrew Coskey

Niki L. Carayannopoulos



INTRODUCTION



  • Pathoanatomy



    • Hamate is a triangular prism-shaped bone in the coronal plane with a large anterior-sided process, the hook of the hamate.


    • Articulates with and bordered by the 4th and 5th metacarpals, pisiform, triquetrum, lunate, and capitate


    • Blood supply



      • Dorsal intercarpal arch—dorsally


      • Branches of the deep palmar arch via retrograde flow—volarly


    • Ligaments



      • Interosseous, dorsal and volar capitohamate ligament


      • Volar and dorsal triquetrohamate ligament


      • Hook of hamate pisiform ligament


      • Three hamatometacarpal ligaments dorsally to the 4th and 5th metacarpals


      • One hamatometacarpal ligament volarly to the 5th metacarpal


    • Extensor carpi ulnaris (ECU) acts as deforming force in fracture or dislocation.


  • Mechanism of injury



    • Direct axial load—closed fist punch



      • Dorsal fracture dislocation of carpometacarpal (CMC) joint1,2,3


      • Coronal dorsal hamate fracture4,5,6,7


    • Blunt force through metacarpal with wrist extended—motorcycle or automobile accident



      • Dorsal fracture dislocation of CMC joint8,9,10,11


    • Direct trauma to the hamate



      • Sagittal split fracture12


      • Nondisplaced with varying comminution13,14


    • Fall on outstretched hand



      • Coronal body (ulnar deviated) or sagittal split (radial deviated) fracture15



    • High-energy injury, crush injury, or perilunate fracture dislocation13,16,17,18,19



      • Transverse fracture


  • Epidemiology

May 7, 2019 | Posted by in ORTHOPEDIC | Comments Off on Hamate Body Fracture
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