CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2023; 64(02): e114-e120
DOI: 10.1055/s-0043-1776306
Case Report

Hamate Metacarpal Fracture Dislocation. Presentation of Four Cases and Literature Review

Article in several languages: español | English
1   Traumatología Extremidad Superior y Microcirugía, Hospital del Trabajador, Santiago, Chile
,
Alberto Hernán Pérez Castillo
2   Ortopedia y Traumatología, Hospital Base Valdivia, Valdivia, Chile
,
Carlos Felipe Muñoz Hernández
3   Equipo de Tobillo y Pie, Traumatología y Ortopedia, Hospital Clínico Universidad de Chile, Santiago, Chile
› Author Affiliations

Abstract

Metacarpal hamate fractures and dislocations comprise a wide range of rare, complex injuries. Their most common cause is hitting solid objects with the fist or sustaining high-energy traumas. The clinical picture consists of pain and swelling in the proximal ulnar side of the hand. Imaging, especially posteroanterior, oblique (30 and 60 degrees), and lateral radiographs, reveals fractures and dislocations, providing a definite diagnosis. Ideally, a computed tomography scan should complement imaging. Treatment is often surgical. Fixation may be percutaneous for optimal closed reduction, but with a low threshold for open reduction using Kirschner wires, screws, or plates to reduce the risk of malunion, post-traumatic osteoarthritis, and chronic pain. We present four patients with an average follow-up of 38 months who underwent surgical treatment in the same medical center, with excellent functional outcomes and mean Disabilities of the Arm, Shoulder, and Hand (DASH) score of 9 points. We also synthesized the available evidence to guide the management of a low-frequency injury with significant prognostic implications.



Publication History

Received: 17 January 2022

Accepted: 03 October 2023

Article published online:
30 October 2023

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