Romain Ceccarelli1, Christian Dumontier2, Olivier Camuzard3. 1. Service de Chirurgie Réparatrice et de la Main, CHU de Nice, Hopital Pasteur 2, Nice. 2. Centre de la Main, Urgences Main, Clinique les Eaux Claires, Baie-Mahault, Guadeloupe, France. 3. Service de Chirurgie Réparatrice et de la Main, CHU de Nice, Hopital Pasteur 2, Nice. Electronic address: camuzard.olivier@hotmail.fr.
Abstract
PURPOSE: Optimal treatment of acute hook of hamate fractures (HHF) remains controversial. Isolated acute HHF can be treated nonsurgically or surgically (with excision of the hook or open reduction internal fixation). The authors present the functional outcomes of a case series of patients who were treated with minimally invasive volar fixation for acute HHF. METHODS: This retrospective study reviewed 6 patients with nondisplaced acute HHF treated with a minimally invasive volar approach and cannulated mini-screw fixation. The development of postoperative complications (tendon and ulnar nerve lesions), pain evaluated using a visual analog scale, and radiological union evaluated on computed tomography scan is reported. Wrist range of motion and grip strength were measured bilaterally. Mayo Wrist Score and Quick-Disabilities of the Arm, Shoulder, and Hand were assessed. All outcomes were measured at 1, 2, 3, and 6 months after surgery. RESULTS: Fixation of HHF through the volar approach was achieved in all cases with no complications. The clinical and radiological union rate was 100%. All patients were able to return to their work or hobbies after an average of 7 weeks. CONCLUSIONS: This study suggests that acute HHF can be treated successfully by open reduction internal fixation using a volar approach with minimal morbidity and complications, a good union rate, and a fast return to daily activities. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic V.
PURPOSE: Optimal treatment of acute hook of hamate fractures (HHF) remains controversial. Isolated acute HHF can be treated nonsurgically or surgically (with excision of the hook or open reduction internal fixation). The authors present the functional outcomes of a case series of patients who were treated with minimally invasive volar fixation for acute HHF. METHODS: This retrospective study reviewed 6 patients with nondisplaced acute HHF treated with a minimally invasive volar approach and cannulated mini-screw fixation. The development of postoperative complications (tendon and ulnar nerve lesions), pain evaluated using a visual analog scale, and radiological union evaluated on computed tomography scan is reported. Wrist range of motion and grip strength were measured bilaterally. Mayo Wrist Score and Quick-Disabilities of the Arm, Shoulder, and Hand were assessed. All outcomes were measured at 1, 2, 3, and 6 months after surgery. RESULTS: Fixation of HHF through the volar approach was achieved in all cases with no complications. The clinical and radiological union rate was 100%. All patients were able to return to their work or hobbies after an average of 7 weeks. CONCLUSIONS: This study suggests that acute HHF can be treated successfully by open reduction internal fixation using a volar approach with minimal morbidity and complications, a good union rate, and a fast return to daily activities. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic V.