유구골 체부 관상면 골절의 치료

Treatment of Hamate Body Coronal Fracture

  • 이상현 (부산대학교 의과대학 부산대학병원 정형외과) ;
  • 김누리 (부산대학교 의과대학 부산대학병원 정형외과) ;
  • 장재훈 (부산대학교 의과대학 부산대학병원 정형외과) ;
  • 안태영 (부산대학교 의과대학 부산대학병원 정형외과)
  • Lee, Sang Hyun (Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University Hospital) ;
  • Kim, Nu Ri (Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University Hospital) ;
  • Jang, Jae Hoon (Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University Hospital) ;
  • Ahn, Tae Young (Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University Hospital)
  • 투고 : 2014.04.15
  • 심사 : 2014.07.08
  • 발행 : 2014.09.30

초록

Purpose: A hamate body coronal fracture is well known as a very rare fracture in the carpal bones and is also hard to diagnose in initial stage due to the bone's architecture. We report our experience in treatment of such a fracture, and we present a review of the relevant literatures. Methods: Four patients who experienced hamate body coronal fractures from October 2006 to October 2013 were enrolled in this study. One patient also had an associated Capitate fracture, and two patients had associated dislocations of the $4^{th}$ metacarpal joint. We performed open reduction and mini-screw fixation on the four patients. In addition, a K-wire was fixed for the two patients with dislocations. Results: The average follow-up period was 24.5 months after surgery, and bone union was observed at the $8^{th}$ week after surgery. We confirmed that bone union had been completed for all the patients, and functional tests showed that joint motion was in the normal range without complications. Conclusion: When a patient has consistent pain on the ulnar side of the wrist, a hamate fracture should be suspected. Computer tomography is better than a simple X-ray scan for confirming the diagnosis of a hamate body coronal fracture. An open reduction and mini-screw fixation led to a good result.

키워드

참고문헌

  1. Milch H. Fracture of the hamate bone. J Bone Joint Surg Am 1934; 16A: 459.
  2. Ebraheim NA, Skie MC, Savolaine ER, Jackson WT. Coronal fracture of the body of the hamate. J Trauma 1995; 38: 169-74. https://doi.org/10.1097/00005373-199502000-00004
  3. Cano Gala C, Pescador Hernandez D, Rendon Diaz DA, Lopez Olmedo J, Blanco Blanco J. Fracture of the body of hamate associated with a fracture of the base of fourth metacarpal: A case report and review of literature of the last 20 years. Int J Surg Case Rep 2013; 4: 442-5. https://doi.org/10.1016/j.ijscr.2013.01.023
  4. Cain JE Jr., Shepler TR, Wilson MR. Hamatometacarpal fracture- dislocation: classification and treatment. J Hand Surg Am 1987; 12: 762-7. https://doi.org/10.1016/S0363-5023(87)80064-3
  5. Fakih RR, Fraser AM, Pimpalnerkar AL. Hamate fracture with dislocation of the ring and little finger metacarpals. J Hand Surg Br 1998; 23: 96-7. https://doi.org/10.1016/S0266-7681(98)80231-3
  6. Lawlis JF, 3rd, Gunther SF. Carpometacarpal dislocations. Long-term follow-up. J Bone Joint Surg Am 1991; 73: 52-9. https://doi.org/10.2106/00004623-199173010-00007
  7. Wharton DM, Casaletto JA, Choa R, Brown DJ. Outcome following coronal fractures of the hamate. J Hand Surg Eur Vol 2010; 35: 146-9.
  8. Robison JE, Kaye JJ. Simultaneous fractures of the capitate and hamate in the coronal plane: case report. J Hand Surg Am 2005; 30: 1153-5. https://doi.org/10.1016/j.jhsa.2005.06.016
  9. Andresen R, Radmer S, Sparmann M, Bogusch G, Banzer D. Imaging of hamate bone fractures in conventional X-rays and high-resolution computed tomography. An in vitro study. Invest Radiol 1999; 34: 46-50. https://doi.org/10.1097/00004424-199901000-00007
  10. O'Shea K, Weiland AJ. Fractures of the hamate and pisiform bones. Hand Clin 2012; 28: 287-300. https://doi.org/10.1016/j.hcl.2012.05.010
  11. Zoltie N. Fractures of the body of the hamate. Injury 1991; 22: 459-62. https://doi.org/10.1016/0020-1383(91)90129-3