Hamate metacarpal injury: a case series and suggested algorithm for treatment.

IF 1.4 Q3 ORTHOPEDICS
Mojahed Sakhnini, George Karkabi, Andrei Nassar, Raphael Lotan, Oded Hershkovich
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引用次数: 0

Abstract

Introduction: Ulnar-sided carpometacarpal fractures and fracture-dislocations are relatively rare but significant injuries due to their impact on hand function. Hamate metacarpal injury represents a trauma to the ulnar corner of the hand. It could lead to fracture of the base of the fourth and fifth metacarpals with associated dislocation. The fourth and fifth carpometacarpal joints have a unique saddle-shaped structure consisting of the metacarpal bases and the distal articular surfaces of the hamate bone. This anatomical design ensures high congruence and significant stability while allowing a variety of movements essential for grip strength and hand dexterity. In this case series, we suggest the term "hamate metacarpal injury" to describe this injury better, as the injury includes dislocation, fracture-dislocation, or impaction to the joint.

Methods: We present and discuss six cases representing the various forms of this injury and the surgical approach and outcome. We propose a classification to sort the different injury patterns and help build a surgical plan.

Results: All six cases recovered with good outcomes. All patients gained a full range of motion with a powerful grip.

Conclusion: The hamate metacarpal injury classification introduces a structured, mechanism-based, and treatment-oriented approach to a complex, often overlooked injury pattern. While further validation in larger cohorts is needed, this system has the potential to streamline diagnosis, guide appropriate interventions, and improve patient outcomes in US-CMC injuries.

钩骨掌骨损伤:一个病例系列和建议的治疗方法。
尺侧腕掌骨骨折和骨折脱位是相对罕见的,但由于其对手部功能的影响而造成严重的伤害。钩状掌骨损伤指的是手部尺角的创伤。这可能导致第四和第五掌骨基部骨折并伴有脱位。第四和第五腕关节具有独特的鞍形结构,由掌骨基部和钩骨的远端关节面组成。这种解剖设计确保了高度一致性和显著的稳定性,同时允许各种运动必不可少的握力和手的灵活性。在本病例系列中,我们建议使用“钩状掌骨损伤”来更好地描述这种损伤,因为这种损伤包括脱位、骨折脱位或关节内嵌。方法:我们提出并讨论了6例代表不同形式的这种损伤的手术方法和结果。我们提出了一个分类来分类不同的损伤模式,并帮助建立一个手术计划。结果:6例患者均恢复良好。所有的病人都获得了全方位的活动和有力的握力。结论:钩骨掌骨损伤分类引入了一种结构化的、基于机制的、以治疗为导向的方法来处理复杂的、经常被忽视的损伤模式。虽然需要在更大的队列中进一步验证,但该系统具有简化诊断、指导适当干预和改善US-CMC损伤患者预后的潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.00
自引率
5.90%
发文量
265
审稿时长
3-8 weeks
期刊介绍: The European Journal of Orthopaedic Surgery and Traumatology (EJOST) aims to publish high quality Orthopedic scientific work. The objective of our journal is to disseminate meaningful, impactful, clinically relevant work from each and every region of the world, that has the potential to change and or inform clinical practice.
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