University of California, San Francisco School of Medicine, Department of Orthopaedic Surgery, San Francisco, CA.
HonorHealth Scottsdale Shea Medical Center, Scottsdale, AZ.
J Hand Surg Am. 2021 Aug;46(8):653-659. doi: 10.1016/j.jhsa.2021.03.015. Epub 2021 Apr 24.
The purpose of this study was to describe an approach to surgical management of the hook of hamate fractures in professional baseball players.
A retrospective chart review was performed on Major and Minor League Baseball players who underwent surgical excision for the hook of hamate fracture between the years 2003 and 2019 by a single surgeon. Patient demographics, the mechanism and timing of the injury, diagnostic and operative details, postoperative complications, and timeline to return to baseball activities were recorded.
A total of 145 professional baseball players affiliated with 17 Major League Baseball organizations were studied, with the majority of athletes playing at the Minor League Baseball level (91.7%). Subacute or chronic patterns of injury (81.7%) were found to be more common than acute patterns based on radiographic and intraoperative findings. Two patients reported transient numbness in the fourth and fifth digits after surgery, 6 patients reported pisotriquetral pain when returning to a hitting program, and 1 patient developed heterotopic ossification after surgery. All complications resolved during a strength and conditioning program. On average, players in our cohort began a hitting program at 4.6 weeks after surgery and were released into full baseball activities at 7.1 weeks after surgery.
Surgical excision remains an effective method of management, with a low risk of minor complications for both acute and chronic hook of hamate fractures in professional baseball players.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic Level IV.
本研究旨在描述一种针对职业棒球运动员钩状骨骨折的手术治疗方法。
对 2003 年至 2019 年间由一位外科医生对钩状骨骨折进行手术切除的大联盟和小联盟棒球运动员进行回顾性图表分析。记录患者的人口统计学数据、损伤的机制和时间、诊断和手术细节、术后并发症以及重返棒球活动的时间线。
共研究了 145 名与 17 个大联盟棒球组织有关联的职业棒球运动员，其中大多数运动员在小联盟棒球级别（91.7%）打球。根据影像学和术中发现，亚急性或慢性损伤模式（81.7%）比急性模式更为常见。2 名患者术后报告第四和第五指短暂麻木，6 名患者返回击球计划时报告pisotriquetral 疼痛，1 名患者术后出现异位骨化。所有并发症都在力量和调理计划中得到解决。在我们的队列中，运动员平均在手术后 4.6 周开始击球计划，在手术后 7.1 周恢复全面的棒球活动。
手术切除仍然是一种有效的治疗方法，对于职业棒球运动员的急性和慢性钩状骨骨折，并发症的风险较低。
研究类型/证据水平：治疗性四级。
