Boulas H J, Milek M A
Indiana Center for Surgery and Rehabilitation of the Hand and Upper Extremity, Indianapolis.
Orthop Rev. 1990 Jun;19(6):518-29.
Four cases of undiagnosed hook of the hamate fracture are presented. In each case, the initial injury was considered trivial; medical attention was not sought until rupture of the little profundus/superficialis tendon occurred. All were treated with excision of the hook and tendon repair, which usually consisted of an end-to-side or "Y" type repair of the little to the ring profundus. Postoperatively, all patients were pain-free; they returned to their respective preinjury activities, although most had some limitation of motion in the digits with the tendon repair. A review of the English literature revealed 127 cases of hook of the hamate fracture, with 14 instances of associated tendon rupture and four histories of tendon fraying. The addition of these four cases constitutes a rupture/injury rate of approximately 14%. Since tendon rupture is a serious problem that not uncommonly follows hook of the hamate fracture, a high index of suspicion must be maintained when initially evaluating these injuries.
本文报告了4例未确诊的钩骨钩骨折病例。在每例病例中，初始损伤都被认为很轻微；直到小指深/浅屈肌腱断裂后才寻求医疗救治。所有患者均接受了钩骨钩切除术和肌腱修复术，修复通常包括小指深屈肌腱与环指深屈肌腱的端侧或“Y”形修复。术后，所有患者均无疼痛；他们恢复了各自受伤前的活动，尽管大多数患者在进行肌腱修复的手指存在一定程度的活动受限。对英文文献的回顾显示，共有127例钩骨钩骨折病例，其中14例伴有肌腱断裂，4例有肌腱磨损史。加上这4例病例，肌腱断裂/损伤率约为14%。由于肌腱断裂是钩骨钩骨折后常见的严重问题，因此在初步评估这些损伤时必须保持高度的怀疑指数。
