Open Access, Peer-reviewed
pISSN 1226-2102
eISSN 2005-8918
    J Korean Orthop Assoc. 2008 Aug;43(4):458-464. Korean.
    Published online Aug 31, 2008.
    https://doi.org/10.4055/jkoa.2008.43.4.458
    Copyright © 2008 The Korean Orthopaedic Association
    Original Article

    Fragment Excision for the Treatment of Hamate Hook Nonunion

    Ho-Jung Kang, M.D., Sung-Hoon Jung, M.D., Joon-Young Jung, M.D., Kwang-Hwan Park, M.D. and Soo-Bong Hahn, M.D.
      • Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.
    • Address reprint requests to Sung-Hoon Jung, M.D. Department of Orthopaedic Surgery, Yongdong Severance Hospital, 146-92, Dogok-dong, Kangnam-gu, Seoul 135-720, Korea. Tel: +82.2-2019-3410, Fax: +82.2-573-5393, Email: doctors@hanmail.net

    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 post-operatively.

    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.

    Keywords
    Hamate hook fracture; Nonunion; Fragment excision

    Figures

    Fig. 1
    A 46-year old man presented with long lasting palmar pain on left hand since having played golf about 11 months ago. (A) On initial carpal tunnel view, nonunion at the base of hamate hook was observed. (B) Hamate hook nonunion was confirmed with CT scan. (C, D) Fragment excision was performed for hamate hook nonunion. (E) Hamate hook excision was confirmed with postoperative carpal tunnel view.

    Fig. 2
    A 41-year old man presented with flexion LOM on right 5th finger. (A) On 3D CT scan, completely separated hamate hook nonunion was observed. (B) Hamate hook excision was performed. (C) Accompanying 5th FDP rupture was also found with hamate hook nonunion. (D) Tendon transfer to 4th FDP was performed for the ruptured 5th FDP.

    Tables

    Table 1
    Summary of Individual Patient Data

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    MeSH Terms
    Carpal Tunnel Syndrome
    Formycins
    Hand Strength
    Humans
    Joints
    Ligaments
    Range of Motion, Articular
    Retrospective Studies
    Ribonucleotides
    Rupture
    Sensation
    Sports
    Tendon Transfer
    Metrics
    Share
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