Tanaka Toshikazu, Yoshii Yuichi
Department of Orthopedics Surgery, Kashiwa Hand Clinic, Kashiwa 2770005, Chiba, Japan.
Department of Orthopaedic Surgery, Tokyo Medical University Ibaraki Medical Center, Ami 3000332, Ibaraki, Japan.
World J Orthop. 2025 Apr 18;16(4):103795. doi: 10.5312/wjo.v16.i4.103795.
Hook of hamate fractures occur either due to repetitive stress from gripping sports (, golf, tennis, and baseball), leading to fatigue fracture, or as a result of trauma from falls or other injuries. The recommended treatment involves the excision of bone fragments to facilitate athletes' early return to sports; excision surgery is also performed in trauma cases. However, some patients prefer nonsurgical treatment options, and conservative treatment should be considered.
To present a case series of 16 patients conservatively treated for hook of hamate fractures.
This study included 16 (11 males and 5 females; right side, 6 cases; left side, 10) patients who desired conservative treatment and could be followed-up until bone union was achieved. The average age of the patients was 49.6 (range: 24-72) years. The average time from injury to consultation was 4.3 (range: 0.2-21.4) weeks. The treatment involved 4 weeks of casting from the forearm to the metacarpophalangeal joint, followed by 8 weeks of splint fixation of the wrist. Follow-up computed tomography scans were performed every 4 weeks.
Bone union was achieved in all patients. The average duration of casting was 3.7 (range: 0-5) weeks and that of splint fixation thereafter was 8.6 (range: 0-28) weeks. The patients did not exhibit joint contractures or range of motion restrictions due to prolonged immobilization.
Conservative treatment with external fixation may be an option for hook of hamate fractures.
钩骨钩骨折的发生,要么是由于抓握类运动(如高尔夫、网球和棒球)产生的重复性应力导致疲劳骨折,要么是跌倒或其他损伤造成的创伤所致。推荐的治疗方法是切除骨碎片,以利于运动员早日重返运动;在创伤病例中也会进行切除手术。然而,一些患者更喜欢非手术治疗方案,因此应考虑保守治疗。
介绍一组16例采用保守治疗的钩骨钩骨折病例。
本研究纳入了16例(11例男性和5例女性;右侧6例,左侧10例)希望接受保守治疗且能够随访至骨折愈合的患者。患者的平均年龄为49.6岁(范围:24 - 72岁)。从受伤到就诊的平均时间为4.3周(范围:0.2 - 21.4周)。治疗方法是从前臂至掌指关节进行4周的石膏固定,随后对腕部进行8周的夹板固定。每4周进行一次随访计算机断层扫描。
所有患者均实现骨折愈合。石膏固定的平均时长为3.7周(范围:0 - 5周),之后夹板固定的平均时长为8.6周(范围:0 - 28周)。患者未因长期固定而出现关节挛缩或活动范围受限的情况。
外固定保守治疗可能是钩骨钩骨折的一种治疗选择。