Jae Kwang Kim1, Sung Joon Shin. 1. Department of Orthopedic Surgery, School of Medicine, Ewha Womans University, Seoul, Republic of Korea. kimjk@ewha.ac.kr
Abstract
PURPOSE: The purpose of this study was to devise a novel classification of a hamatometacarpal fracture-dislocation based on the preoperative computed tomography (CT) and plain radiography that provided more information to surgeons regarding appropriate treatment methods. MATERIALS AND METHODS: Twenty-one patients with a hamatometacarpal fracture-dislocation were enrolled in this study. The classification scheme devised for hamatometacarpal fracture-dislocation is summarised as follows: type I - a simple dislocation; type IIA - a dislocation with the fourth metacarpal base intra-articular fracture; type IIB - a dislocation with a dorsal hamate fracture of less than one-third of the articular surface; and type III - a dislocation with a dorsal hamate fracture of more than one-third of the articular surface. RESULTS: Type I injury was treated conservatively after closed reduction. Type IIA and IIB injuries were treated by percutaneous K-wire fixation. Type III injury was treated by open reduction and internal fixation. All injuries were well managed in both clinical and radiographic evaluations, without apparent complications. CONCLUSION: The novel classification system for hamatometacarpal fracture-dislocation can be used to establish guidelines for appropriate treatment.
PURPOSE: The purpose of this study was to devise a novel classification of a hamatometacarpal fracture-dislocation based on the preoperative computed tomography (CT) and plain radiography that provided more information to surgeons regarding appropriate treatment methods. MATERIALS AND METHODS: Twenty-one patients with a hamatometacarpal fracture-dislocation were enrolled in this study. The classification scheme devised for hamatometacarpal fracture-dislocation is summarised as follows: type I - a simple dislocation; type IIA - a dislocation with the fourth metacarpal base intra-articular fracture; type IIB - a dislocation with a dorsal hamate fracture of less than one-third of the articular surface; and type III - a dislocation with a dorsal hamate fracture of more than one-third of the articular surface. RESULTS:Type I injury was treated conservatively after closed reduction. Type IIA and IIB injuries were treated by percutaneous K-wire fixation. Type III injury was treated by open reduction and internal fixation. All injuries were well managed in both clinical and radiographic evaluations, without apparent complications. CONCLUSION: The novel classification system for hamatometacarpal fracture-dislocation can be used to establish guidelines for appropriate treatment.