Naito Kiyohito, Yoshikawa Kei, Kaneko Kazuo, Obayashi Osamu
Department of Orthopaedic Surgery, Juntendo University Shizuoka Hospital, Japan.
Hand Surg. 2013;18(3):417-20. doi: 10.1142/S0218810413720283.
Hamate hook non-union is a relatively rare, but on the increase. We encountered a 25-year-old male baseball instructor with hamate hook non-union, and treated it with debridement of the fractured region and osteosynthesis using a break-away screw. Splint fixation was applied for three weeks after surgery, and active/passive range of motion exercises were actively performed thereafter. Bone union was noted three months after surgery. Transient ulnar paralysis resolved, and the patient could return to the same sports activity as that before injury six months after surgery. Since break-away screws are capable of loading a strong pressure on the fractured region and these screws can be inserted by preparing only a surgical field for guide wire insertion, requiring no soft tissue dissection to prepare a region for applying fixation materials, break-away screws are useful for the fixation of small bone fragments and osteosynthesis in a deep surgical field.
钩骨钩不愈合相对少见，但有增多趋势。我们遇到一名25岁男性棒球教练，患有钩骨钩不愈合，采用骨折部位清创及使用可折断螺钉进行骨合成治疗。术后用夹板固定3周，之后积极进行主动/被动活动度锻炼。术后3个月观察到骨愈合。短暂性尺神经麻痹消失，患者术后6个月能够恢复到受伤前同样的体育活动。由于可折断螺钉能够在骨折部位施加强大压力，且仅通过准备用于插入导丝的手术区域即可插入这些螺钉，无需进行软组织剥离来准备应用固定材料的区域，因此可折断螺钉对于固定小骨碎片及在深部手术区域进行骨合成很有用。
