Classification and treatment of hamate fractures.

Twenty-nine patients with hamate fractures were treated. The two main types of hamate fractures are hook fractures (type 1) and body fractures (type 2). We sub-divided type 2 fractures according to the fracture line into coronal, type 2a and transverse, type 2b. There were 15 type 1, 11 type 2a and three type 2b fractures. For type 1, nine were treated with excision, one with open reduction and internal fixation (ORIF) and five with cast immobilisation, in which two resulted in non-union followed by excision. For type 2, five type 2a cases were treated with ORIF and the others with closed reduction and pinning. Most of the patients had satisfactory results at the seventh month follow-up. However, those with associated neurovascular and musculotendinous injuries were likely to have unfavourable results. On the basis of study findings, it appears that functional results are influenced mainly by the associated soft tissue damage.