Ta Canhnghi N, Finley Zachary, Medvedev Gleb A
Tulane University School of Medicine, New Orleans, La.
Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, La.
Plast Reconstr Surg Glob Open. 2022 May 24;10(5):e4352. doi: 10.1097/GOX.0000000000004352. eCollection 2022 May.
Hamate fractures are an infrequent injury and are often missed or have a delayed diagnosis with potential for significant patient morbidity. There is a relative paucity in the literature involving large population studies of hamate fractures and subsequent complications. Gaining a better understanding of complications associated with nonoperative management will help guide the decision for operative intervention.
The PearlDiver patient records database was used to query for patients who sustained a hamate fracture using ICD-9 and ICD-10 codes. Postinjury complications within 1 year of diagnosis were assessed using ICD-9 and ICD-10 codes for diagnoses of complications.
A total of 1120 patients who sustained a hamate hook or body fracture met inclusion and exclusion criteria and were included in the study. Patients who were managed nonoperatively showed a nonunion rate of 2%, ulnar neuropathy rate of 1.7%, and tendon rupture rate of 0.2%. In a subanalysis using only ICD-10 codes to distinguish between hook and body fractures, hook fractures demonstrated a nonunion rate of 2.2%, ulnar neuropathy rate of 2.7%, and tendon rupture rate of 0%, while body fractures had a nonunion rate of 1.2%, ulnar neuropathy rate of 1%, and tendon rupture rate of 0%.
The current study shows very low rates of nonunion, ulnar neuropathy and tendon rupture after nonoperative management of hamate fractures.
钩骨骨折是一种罕见的损伤，常被漏诊或诊断延迟，可能导致患者出现严重的并发症。目前关于钩骨骨折及后续并发症的大样本研究相对较少。更好地了解非手术治疗相关的并发症将有助于指导手术干预的决策。
使用PearlDiver患者记录数据库，通过ICD - 9和ICD - 10编码查询发生钩骨骨折的患者。使用ICD - 9和ICD - 10编码评估诊断后1年内的损伤后并发症。
共有1120例发生钩骨钩或钩骨体骨折的患者符合纳入和排除标准并纳入研究。非手术治疗的患者骨不连发生率为2%，尺神经病变发生率为1.7%，肌腱断裂发生率为0.2%。在仅使用ICD - 10编码区分钩骨钩骨折和钩骨体骨折的亚分析中，钩骨钩骨折的骨不连发生率为2.2%，尺神经病变发生率为2.7%，肌腱断裂发生率为0%；而钩骨体骨折的骨不连发生率为1.2%，尺神经病变发生率为1%，肌腱断裂发生率为0%。
目前的研究表明，钩骨骨折非手术治疗后骨不连、尺神经病变和肌腱断裂的发生率非常低。
