Department of Surgery, Division of Plastic and Reconstructive Surgery.
Department of Orthopaedic Surgery, Washington University, St. Louis, MO.
Tech Hand Up Extrem Surg. 2020 Dec;24(4):187-193. doi: 10.1097/BTH.0000000000000290.
Fractures of the hamate are relatively rare and there is a paucity of literature describing their natural history, indications for operative fixation, surgical techniques, and outcomes. Most authors recommend operative fixation of displaced intra-articular coronal hamate body fractures, and a dorsal approach with Kirschner wires has most commonly been recommended to achieve this. In this report, a 2-incision approach to the hamate is presented that facilitates rigid internal fixation of coronal hamate body fractures with a cannulated headless compression screw and minimizes the possibility of iatrogenic injury to critical branches of the ulnar nerve. The authors summarize a series of 2 patients with displaced, intra-articular coronal hamate body fractures of differing severity treated successfully with the proposed approach.
钩骨骨折相对较少见，其自然病史、手术适应证、手术技术和结果的相关文献也较少。大多数作者建议对关节内冠状钩骨体移位骨折进行手术固定，最常推荐采用背侧入路和克氏针来实现这一目标。本报告提出一种钩骨的两切口入路方法，可通过无头加压空心螺钉实现对冠状钩骨体骨折的牢固内固定，并最大限度地减少对尺神经关键分支的医源性损伤的可能性。作者总结了 2 例不同严重程度的关节内冠状钩骨体移位骨折患者，成功地采用了该入路方法进行治疗。
