Devers Brandon N, Douglas Keith C, Naik Rishi D, Lee Donald H, Watson Jeffry T, Weikert Douglas R
Vanderbilt University Medical Center, Vanderbilt Orthopaedic Institute, Nashville, TN 37232-8774, USA.
J Hand Surg Am. 2013 Jan;38(1):72-6. doi: 10.1016/j.jhsa.2012.10.011. Epub 2012 Nov 30.
To determine the overall long-term postoperative clinical and functional results of high-level amateur athletes after hook of hamate excision, based on complications; return to sport; Disabilities of the Arm, Shoulder, and Hand (DASH) score; and a self-reported questionnaire.
We evaluated 11 patients representing 12 cases of hook of hamate excision. All patients were high-level amateur athletes (rising collegiate or collegiate level). We performed a retrospective chart review to elicit information pertaining to the patient's injury. We assessed long-term postoperative outcomes with a self-reported questionnaire, the DASH form, and the DASH Sport/Performing Arts Module form.
All patients successfully returned to full participation in their respective sports an average of 6 weeks after surgery. The average postoperative DASH score was less than 1, and all patients scored a 0 on the DASH Sports form. There was a significant improvement in preoperative pain after surgical intervention. There was no significant difference between preinjury and postoperative performance scores. Finally, every patient was very satisfied with the surgical outcome. There was only 1 postoperative complication in which a patient developed transient ulnar nerve paresthesias, which completely resolved by 6 weeks after surgery.
Surgical excision of hook of hamate fractures in high-level amateur athletes allows for successful return to sports participation at preinjury performance levels, achievement of normal function as measured by validated objective outcome measures, significant reduction in pain, and high overall patient satisfaction. We consider surgical excision to be a safe and effective technique to restore normal function and hasten return to play for high-level amateur athletes.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
基于并发症、恢复运动情况、上肢、肩部和手部功能障碍（DASH）评分以及一份自我报告问卷，确定高水平业余运动员在钩骨钩切除术后的长期临床和功能总体结果。
我们评估了11例患者的12例钩骨钩切除术病例。所有患者均为高水平业余运动员（大学预科或大学水平）。我们进行了回顾性病历审查，以获取与患者损伤相关的信息。我们通过一份自我报告问卷、DASH表格以及DASH运动/表演艺术模块表格评估术后长期结果。
所有患者在术后平均6周成功恢复到能完全参与各自的运动项目。术后DASH评分平均低于1分，且所有患者在DASH运动表格上的得分均为0分。手术干预后术前疼痛有显著改善。伤前和术后表现评分之间无显著差异。最后，每位患者对手术结果都非常满意。术后仅出现1例并发症，一名患者出现短暂性尺神经感觉异常，在术后6周完全缓解。
对高水平业余运动员的钩骨钩骨折进行手术切除，能使他们成功恢复到伤前的运动参与水平，通过有效的客观结果测量指标衡量可实现正常功能，疼痛显著减轻，患者总体满意度较高。我们认为手术切除是一种安全有效的技术，可恢复高水平业余运动员的正常功能并加速其重返赛场。
研究类型/证据水平：治疗性IV级
