Parker R D, Berkowitz M S, Brahms M A, Bohl W R
Am J Sports Med. 1986 Nov-Dec;14(6):517-23. doi: 10.1177/036354658601400617.
Five patients have been treated for six hook of the hamate fractures over the past 8 years by the authors. Of these, four patients were professional baseball players and one patient was an accountant. All fractures occurred while playing baseball; four while swinging a bat, and two secondary to a fall on an outstretched hand. Roentgenographic diagnosis was made by carpal tunnel view alone in two, oblique and carpal tunnel view in one, bone scan and subsequent carpal tunnel view in two, and computerized tomography in one fracture. Five of the fractures were through the base of the hook, while one was toward the tip. All patients ultimately underwent hook resection, four early and two late. The patient who sustained the tip of the hook fracture underwent resection of the fracture only to refracture the same hook at its base 6 months later. All patients returned to their previous level of activity in 6 to 8 weeks after surgery without loss of function. Hence, it is the authors' opinion that the entire hook should be resected to the base of the hamate as the primary form of treatment in hook of the hamate fractures.
在过去8年里,作者共治疗了5例钩骨钩骨折患者,共6处骨折。其中,4例患者为职业棒球运动员,1例患者为会计。所有骨折均发生在打棒球时,4例是在挥棒击球时发生,2例是因伸手跌倒所致。仅通过腕管位X线片诊断出2例骨折,1例通过斜位和腕管位X线片诊断,2例通过骨扫描及后续腕管位X线片诊断,1例骨折通过计算机断层扫描诊断。5处骨折位于钩骨钩基底部,1处骨折靠近钩尖。所有患者最终均接受了钩骨切除术,4例早期手术,2例晚期手术。钩尖骨折的患者仅切除了骨折部位,但6个月后钩骨基底部再次骨折。所有患者术后6至8周恢复到术前的活动水平,且功能未丧失。因此,作者认为,对于钩骨钩骨折,应将整个钩骨钩切除至基部切除作为主要治疗方式。