Pruzansky M, Arnold L
Department of Orthopaedics, Mount Sinai School of Medicine, New York, NY.
Orthop Rev. 1987 Sep;16(9):624-8.
Delayed union of fractures of the trapezoid and body of the hamate are rare and difficult to treat. The fracture fragments may include the neighboring metacarpals with the insertions of the wrist extensors. These two cases occurred after direct blows to the bases of the 2nd and 5th metacarpals, respectively. The extensor carpi radialis longus and extensor carpi ulnaris are deforming forces that may delay osseous union when cast immobilization alone is used. Early internal fixation is advocated for even minimally displaced fractures of the trapezoid or hamate when accompanied by intra-articular fragments of metacarpal with their tendinous insertions.
大多角骨和钩骨体骨折的延迟愈合罕见且难以治疗。骨折碎片可能包括附着有腕伸肌的相邻掌骨。这两例分别发生于第2和第5掌骨基底受到直接打击之后。桡侧腕长伸肌和尺侧腕伸肌是致畸形力，单独使用石膏固定时可能会延迟骨愈合。对于大多角骨或钩骨即使是轻微移位的骨折，若伴有掌骨的关节内骨折碎片及其肌腱附着点，提倡早期内固定。
