Optimal treatment of acute hook of hamate fractures (HHF) remains controversial. Isolated acute HHF can be treated nonsurgically or surgically (with excision of the hook or open reduction internal fixation). The authors present the functional outcomes of a case series of patients who were treated with minimally invasive volar fixation for acute HHF.
This retrospective study reviewed 6 patients with nondisplaced acute HHF treated with a minimally invasive volar approach and cannulated mini-screw fixation. The development of postoperative complications (tendon and ulnar nerve lesions), pain evaluated using a visual analog scale, and radiological union evaluated on computed tomography scan is reported. Wrist range of motion and grip strength were measured bilaterally. Mayo Wrist Score and Quick-Disabilities of the Arm, Shoulder, and Hand were assessed. All outcomes were measured at 1, 2, 3, and 6 months after surgery.
Fixation of HHF through the volar approach was achieved in all cases with no complications. The clinical and radiological union rate was 100%. All patients were able to return to their work or hobbies after an average of 7 weeks.
This study suggests that acute HHF can be treated successfully by open reduction internal fixation using a volar approach with minimal morbidity and complications, a good union rate, and a fast return to daily activities.
Type of study/level of evidence
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- Hook of the hamate fractures: diagnosis, treatment, and complications.Orthop Rev. 1990; 19: 518-529
- Outcomes of hook of hamate fracture excision in high-level amateur athletes.J Hand Surg Am. 2013; 38: 72-76
- Hook of hamate fractures in competitive baseball players.Hand (N Y). 2013; 8: 302-307
- Return to play and complications after hook of the hamate fracture surgery.J Hand Surg Am. 2017; 42: 803-809
- Hook of hamate pull test.J Hand Surg Am. 2010; 35: 1887-1889
- Fracture of the hamate hook.J Hand Surg Am. 1988; 13: 135-139
- Fracture of the hook of the hamate.AJR Am J Roentgenol. 1979; 133: 899-903
- The imaging of hamate fractures in the conventional X-ray and CT: experimental results and clinical experiences [in German].Rofo. 1998; 169: 53-57
- Diagnosis and management of hook of hamate fractures.J Hand Surg Eur Vol. 2018; 43: 539-545
- Therapeutic alternatives in nonunion of hamate hook fractures: personal experience in 8 patients and review of literature.Ann Plast Surg. 2005; 55: 149-154
- Symptomatic, partial union of the hook of the hamate fracture in athletes.Am J Sports Med. 2003; 31: 106-111
- Hook of hamate fractures.J Hand Surg Am. 2013; 38: 2457-2460
- The arterial anatomy of the human carpus. Part II: the intraosseous vascularity.J Hand Surg Am. 1983; 8: 375-382
- Hook of hamate fractures: critical evaluation of different therapeutic procedures.Plast Reconstr Surg. 2005; 115: 488-497
- Diagnosis and management of hamate hook fractures.Hand Clin. 2000; 16: 397-403
- Fracture of the hook of the hamate.J Bone Joint Surg Am. 1989; 71: 1202-1207
- Excision of the hook of the hamate: a retrospective survey and review of the literature.J Hand Surg Am. 1988; 13: 612-615
- Minimal invasive fixation of hamate hook fractures through a dorsal percutaneous approach using a mini compression screw: an experimental feasibility study.Eur J Trauma Emerg Surg. 2009; 35: 397-402
- Scaphoid malunion.J Hand Surg Am. 1989; 14: 679-687
- Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG).Am J Ind Med. 1996; 29: 602-608
- Patient with a hook of the hamate fracture presenting as vascular occlusion: diagnosis made with bedside ultrasound.J Emerg Med. 2016; 51: 63-65
- Biomechanical evaluation of flexor tendon function after hamate hook excision.J Hand Surg Am. 2003; 28: 138-143
- Hamate hook nonunion treated with a hook plate: case report and surgical technique.Tech Hand Up Extrem Surg. 2012; 16: 194-197
- Fracture of the hook of the hamate: acute treatment.J Trauma. 1993; 34: 803-805
Published online: February 20, 2019
Accepted: January 14, 2019
Received: March 10, 2018
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
© 2019 by the American Society for Surgery of the Hand. All rights reserved.