Wang Bin, Hu Jianwei, Zhang Xuebai, Yang Huanyou, Ma Tiepeng, Zhao Jinhai, Yin Jiali, Liu Dequn
Department of Hand Surgery, the Second Hospital of Tangshan, Tangshan Hebei, 063000, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2010 Jan;24(1):60-3.
To study the hook of hamate bone by anatomy and iconography methods in order to provide information for the clinical treatment of injuries to the hook of hamate bone and the deep branch of ulnar nerve.
Fifty-two upper limb specimens of adult corpses contributed voluntarily were collected, including 40 antisepticized old specimens and 12 fresh ones. The hook of hamate bone and its adjacent structure were observed. Twenty-four upper limbs selected randomly from specimens of corpses and 24 upper limbs from 12 healthy adults were investigated by computed tomography (CT) three-dimensional reconstruction, and then related data were measured. The measurement results of 24 specimens were analyzed statistically.
The hook of hamate bone is an important component of ulnar carpal canal and carpal canal, and the deep branch of ulnar nerve is located closely in the inner front of the hook of hamate bone. The flexor tendons of the forth and the little fingers are in the innermost side, closely lie next to the outside of the hook of hamate bone. The hamate bone located between the capitate bone and the three-cornered bone with wedge-shaped. The medial-, lateral-, and front-sides are all facies articularis. The hook of hamate bone has an approximate shape of a flat plate. The position migrated from the body of the hamate bone, the middle of the hook and the enlargement of the top of the hook were given the names of "the basis of the hook", "the waist of the hook", and "the coronal of the hook", respectively. The short path of the basement are all longer than the short path of the waist. The long path of the top of the hook is the maximum length diameter of the hook of hamate bone, and is longer than the long path of the basement and the long path of the waist. The iconography shape and trait of the hook of hamate bone is similar to the anatomy result. There were no statistically significant differences (P > 0.05) between two methods in the seven parameters as follows: the long path of the basement of the hook, the short path of the basement of the hook, the long path of the waist of the hook, the short path of the waist of the hook, the long path of the top of the hook, the height of the hook, of hamate bone, and the distance between the top and the waist of the hook.
The hook of hamate bone can be divided into three parts: the coronal part, the waist part, and the basal part; fracture of the hamate bone can be divided into fracture of the body, fracture of the hook, and fracture of the body and the hook. Fracture of the hook of hamate bone or fracture union can easily result in injure of the deep branch of ulnar nerve and the flexor tendons of the forth and the little fingers. The measurement results of CT three-dimensional reconstruction can be used as reference value directly in clinical treatments.
采用解剖学与影像学方法对钩骨钩进行研究，为临床治疗钩骨钩及尺神经深支损伤提供资料。
收集自愿捐献的52例成人上肢标本，其中防腐保存的陈旧标本40例，新鲜标本12例。观察钩骨钩及其毗邻结构。随机选取尸体标本中的24例上肢及12例健康成人的24例上肢行CT三维重建，并测量相关数据。对24例标本的测量结果进行统计学分析。
钩骨钩是腕尺管及腕管的重要组成部分，尺神经深支紧邻钩骨钩内前方走行。环指和小指屈肌腱位于最内侧，紧邻钩骨钩外侧。钩骨位于头状骨与三角骨之间，呈楔形，内、外、前面均为关节面。钩骨钩近似平板状，将其从钩骨体移行处、钩中部及钩尖膨大处分别命名为“钩基”“钩腰”“钩冠”。钩基短径均长于钩腰短径。钩尖长径为钩骨钩的最大长径，长于钩基长径及钩腰长径。钩骨钩的影像学形态及特征与解剖学结果相似。钩基长径、钩基短径、钩腰长径、钩腰短径、钩尖长径、钩骨钩高度、钩尖与钩腰间距7项参数两种方法测量结果比较差异均无统计学意义（P＞0.05）。
钩骨钩可分为冠部、腰部和基部三部分；钩骨骨折可分为体部骨折、钩部骨折、体部与钩部联合骨折。钩骨钩骨折或骨折愈合易导致尺神经深支及环指和小指屈肌腱损伤。CT三维重建测量结果可直接作为临床治疗的参考值。
