Abstract
Background Avascular necrosis of the hamate (hamate-AVN) is a seldom reported disease of which
little is known on etiology, best treatment modalities, and outcome. Hamate-AVN can
occur in multiple locations within the hamate.
Case Description Case one was an 8-year-old girl with painful AVN of the hamate hook. Surgical excision
of the hook was performed, leading to excellent results (follow-up 8 years). Case
two was a 44-year-old man with hamate-AVN of the proximal pole surgically treated
with a vascularized bone graft from the radius based on the fifth extensor compartment
artery, leading to excellent results (follow-up 7 years). Case three was a 36-year-old
woman with hamate-AVN of the proximal pole surgically treated with débridement and
cancellous bone grafting, leading to poor results (follow-up 1 year).
Literature Review Nine other cases of avascular necrosis of the hamate were found in literature, all
but one treated surgically. Etiology, treatment, and results of these cases, combined
with our own cases, are reviewed.
Clinical Relevance This article summarizes and synthesizes all presented cases of avascular necrosis
of the hamate. We hope this will be helpful to physicians in decision making when
confronted with this rare entity.
Level of Evidence 4
Keywords
avascular - hamate - necrosis - osteonecrosis - treatment
