Hollow screw in treatment of basilar part fracture of hamate hook_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 YANG Huanyou , WANG Bin , LI Ruiguo , ZHANG Jian

No.1 Department of Hand Surgery, the Second Hospital of Tangshan, Tangshan Hebei, 063000, P.R.China;

Corresponding?author：

YANG Huanyou, Email: yanghuanyou123@126.com

Keywords：

Hamate hook fracture; hollow screw; open reduction; internal fixation

DOI：

10.7507/1002-1892.201908114

Video：

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Objective To explore the effectiveness of hollow screw for the treatment of basilar part fracture of hamate hook.Methods Five patients with basilar part fracture of hamate hook, aged 24-47 years (mean, 31 years) were treated with open reduction and hollow screw fixation between June 2015 and February 2019. There were 4 males and 1 female. The causes of injury were athletic injury in 3 cases, falling injury in 1 case, and crushing injury in 1 case. Among them, 1 case was combined with sensory disturbance of one and a half fingers on the ulnar side of the palm. The grip strength of the affected side was significantly decreased when compared with that of the healthy side in all patients. The intervals between injury and surgery were 3-8 days (mean, 4.2 days). Postoperative follow-up was conducted regularly to measure the grip strength of the affected and healthy fingers and the total motion of ring and little fingers of the affected side. Darrow criteria was used to evaluate the effectiveness.Results All the incisions healed by primary intention. All the patients were followed up 6-32 months (mean, 16 months). X-ray films showed that the basilar part fracture of hamate hook reached bony union, and the healing time was 2.0-3.5 months (mean, 2.2 months). At last follow-up, the grip strength of the affected side was (35.80±3.76) kg, showing no significant difference when compared with healthy side [(36.00±4.94) kg] (t=0.094, P=0.930); and the total motion of ring and little fingers of the affected side was (529.0±8.9)°, which was significantly different from that before operation [(232.0±34.7)°] (t=18.108, P=0.000). In 1 patient with ulnar nerve injury, the two-point discrimination of the innervation area was 4 mm, and the pain sensation and temperature sensation returned to normal. Assessed by Darrow criteria, the results were excellent in 4 cases and good in 1 case.Conclusion For the basilar part fracture of hamate hook, hollow screw fixation can obtain secure reduction and fixation and provide sustained compression and counter-rotation for the broken end of fracture, thus allowing early joint motion and promoting fracture healing and recovery of wrist function. It is a relatively good method for the treatment of basilar part fracture of hamate hook.

Citation： YANG Huanyou, WANG Bin, LI Ruiguo, ZHANG Jian. Hollow screw in treatment of basilar part fracture of hamate hook. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(4): 489-492. doi: 10.7507/1002-1892.201908114 Copy

1.	熊革, 戴魯飛, 鄭煒, 等. 鉤骨鉤骨折的臨床分型與治療. 中華手外科雜志, 2011, 27(5): 269-272.
2.	陳振兵, 洪光祥, 王發斌. 鉤骨鉤部骨折四例報告及文獻復習. 中華手外科雜志, 2004, 20(1): 3-4.
3.	Darrow JC Jr, Linscheid RL, Dobyns JH, et al. Distal ulnar recession for disorders of the distal radioulnar joint. J Hand Surg (Am), 1985, 10(4): 482-491.
4.	Walsh JJ 4th, Bishop AT. Diagnosis and management of hamate hook fractures. Hand Clin, 2000, 16(3): 397-403.
5.	楊勇, 武競衡, 孫麗穎, 等. 微型鈦板經腕掌關節固定治療鉤骨體冠狀面骨折. 中華骨科雜志, 2017, 37(2): 105-112.
6.	Cain JE Jr, Shepler TR, Wilson MR. Hamatometacarpal fracture-dislocation: classification and treatment. J Hand Surg (Am), 1987, 12(5 Pt 1): 762-767.
7.	Ebraheim NA, Skie MC, Savolaine ER, et al. Coronal fracture of the body of the hamate. J Trauma, 1995, 38(2): 169-174.
8.	熊革, 王澍寰. 腕關節疾病檢查圖解. 北京: 人民軍醫出版社, 2005: 106-108.
9.	郜永斌, 田光磊, 殷耀斌. 鉤骨體部骨折的分型與治療. 中國骨與關節雜志, 2014, 3(3): 168-171.
10.	O’Shea K, Weiland AJ. Fractures of the hamate and pisiform bones. Hand Clin, 2012, 28(3): 287-300.
11.	楊晨光, 陳亮, 胡韶楠. 急性腕舟骨骨折的診斷治療研究進展. 中國修復重建外科雜志, 2019, 33(4): 507-510.
12.	Stark HH, Chao EK, ZemeL NP, et al. Fracture of the hook of the hamate. J Bone Joint Surg (Am), 1989, 71A: 1202-1207.
13.	Andresen R, Radmer S, Sparmann M, et al. Imaging of hamate bone fractures in conventional X-rays and high-resolution computed tomography. An in vitro study. Invest Radiol, 1999, 34(1): 46-50.
14.	Demirkan F, Calandruccio JH, Diangelo D. Biomechanical evaluation of flexor tendon function after hamate hook excision. J Hand Surg (Am), 2003, 28(1): 138-143.
15.	王斌, 李浩, 楊煥友, 等. 單純鉤骨鉤骨折致尺神經深支損傷的臨床研究. 中國骨與關節損傷雜志, 2012, 27(7): 598-600.
16.	李春江. 旋轉加壓張力帶固定法治療鉤骨鉤部骨折. 中華手外科雜志, 2016, 32(4): 255-256.
17.	Freeland AE, Finley JS. Displaced dorsal oblique fracture of the hamate treated with a cortical mini lag screw. J Hand Surg (Am), 1986, 11(5): 656-658.
18.	段亮, 弓立群, 范亞一, 等. 無頭加壓中空埋入螺釘內固定治療肘關節內骨折的療效. 中國修復重建外科雜志, 2019, 33(8): 986-990.

1. 熊革, 戴魯飛, 鄭煒, 等. 鉤骨鉤骨折的臨床分型與治療. 中華手外科雜志, 2011, 27(5): 269-272.
2. 陳振兵, 洪光祥, 王發斌. 鉤骨鉤部骨折四例報告及文獻復習. 中華手外科雜志, 2004, 20(1): 3-4.
3. Darrow JC Jr, Linscheid RL, Dobyns JH, et al. Distal ulnar recession for disorders of the distal radioulnar joint. J Hand Surg (Am), 1985, 10(4): 482-491.
4. Walsh JJ 4th, Bishop AT. Diagnosis and management of hamate hook fractures. Hand Clin, 2000, 16(3): 397-403.
5. 楊勇, 武競衡, 孫麗穎, 等. 微型鈦板經腕掌關節固定治療鉤骨體冠狀面骨折. 中華骨科雜志, 2017, 37(2): 105-112.
6. Cain JE Jr, Shepler TR, Wilson MR. Hamatometacarpal fracture-dislocation: classification and treatment. J Hand Surg (Am), 1987, 12(5 Pt 1): 762-767.
7. Ebraheim NA, Skie MC, Savolaine ER, et al. Coronal fracture of the body of the hamate. J Trauma, 1995, 38(2): 169-174.
8. 熊革, 王澍寰. 腕關節疾病檢查圖解. 北京: 人民軍醫出版社, 2005: 106-108.
9. 郜永斌, 田光磊, 殷耀斌. 鉤骨體部骨折的分型與治療. 中國骨與關節雜志, 2014, 3(3): 168-171.
10. O’Shea K, Weiland AJ. Fractures of the hamate and pisiform bones. Hand Clin, 2012, 28(3): 287-300.
11. 楊晨光, 陳亮, 胡韶楠. 急性腕舟骨骨折的診斷治療研究進展. 中國修復重建外科雜志, 2019, 33(4): 507-510.
12. Stark HH, Chao EK, ZemeL NP, et al. Fracture of the hook of the hamate. J Bone Joint Surg (Am), 1989, 71A: 1202-1207.
13. Andresen R, Radmer S, Sparmann M, et al. Imaging of hamate bone fractures in conventional X-rays and high-resolution computed tomography. An in vitro study. Invest Radiol, 1999, 34(1): 46-50.
14. Demirkan F, Calandruccio JH, Diangelo D. Biomechanical evaluation of flexor tendon function after hamate hook excision. J Hand Surg (Am), 2003, 28(1): 138-143.
15. 王斌, 李浩, 楊煥友, 等. 單純鉤骨鉤骨折致尺神經深支損傷的臨床研究. 中國骨與關節損傷雜志, 2012, 27(7): 598-600.
16. 李春江. 旋轉加壓張力帶固定法治療鉤骨鉤部骨折. 中華手外科雜志, 2016, 32(4): 255-256.
17. Freeland AE, Finley JS. Displaced dorsal oblique fracture of the hamate treated with a cortical mini lag screw. J Hand Surg (Am), 1986, 11(5): 656-658.
18. 段亮, 弓立群, 范亞一, 等. 無頭加壓中空埋入螺釘內固定治療肘關節內骨折的療效. 中國修復重建外科雜志, 2019, 33(8): 986-990.

Chinese Journal of Reparative and Reconstructive Surgery

Hollow screw in treatment of basilar part fracture of hamate hook

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