Operative treatment of hamate fractures with hamatometacarpal fracture dislocation using a self-designed dorsal buttress locking plate with trans-metacarpal pin insertion: short-term follow-up results

Purpose: Fracture and dislocation of the hamatometacarpal joint are rare; therefore, the diagnosis is frequently missed and the treatment is not clearly established. The authors performed operative treatment of hamate fractures with hamatometacarpal fracture dislocation using a self-designed dorsal buttress locking plate. Herein, we report the clinical and radiological results.Methods: From May 2016 to February 2022, we experienced 12 cases of hamatometacarpal fracture dislocation that underwent operative treatment with a self-designed dorsal buttress locking plate. All 12 patients were male, with an average age of 30.3 years and an average postoperative follow-up period of 6 months and 1 week. Open reduction and internal fixation were performed using a self-designed dorsal buttress locking plate with trans-metacarpal pin insertion according to the patient, and the results of the treatment were evaluated radiologically and clinically.Results: All cases showed bony union in radiological evaluations at the last follow-up. In functional evaluations using the modified Mayo wrist score, the results were excellent in 11 cases and good in 1 case. There were no complications such as fixation failure, nonunion, or infection.Conclusion: In cases of hamate fracture with hamatometacarpal fracture dislocation, the dorsal displaced fragment is very small, and it is often difficult to maintain reduction by direct fixation. In these fractures, operative treatment using a self-designed dorsal buttress locking plate with trans-metacarpal pin insertion can obtain good results.