Titanium miniplates across the fourth and fifth carpometacarpal joints for coronal fractures of the hamate
SUN Li-ying
YANG Yong
LI Zhong-zhe
TIAN Wen
Abstract：Objective To evaluate the result of coronal fractures of the hamate with titanium miniplates across the fourth and fifth carpometacarpal joints. Methods From December 2011 to September 2018, 24 patients with coronal fractures of the hamate were managed with titanium miniplates across the carpometacarpal joints. All patients were males with an average age of ( 29.6 ± 7.9 ) years ( range: 18 - 51 years ). Ebraheim's classification of hamate fractures: 3 cases were of type A, 8 type B, and 13 type C. All fractures were exposed using the dorsal approach. After reduction, the fractures were fixed with titanium miniplates crossing the carpometacarpal joints dorsally. The Disabilities of the Arm, Shoulder and Hand ( DASH ), Visual Analogue Scale ( VAS ), MAYO Wrist Score, grip strength, and TAM ( total active motion ) of ring and little fingers were recorded to evaluate outcomes. Results All 24 patients were followed up for 13 - 44 months ( mean: 18.5 ± 8.3 months ). Hamate fractures healed within 6 - 10 weeks ( mean: 6.9 ± 1.1 weeks ). Except two cases, all titanium miniplates and screws were removed at 3 to 6 months after surgery. Evaluation indexes at the final follow-up: DASH scores 0 - 10.8 ( mean: 1.7 ± 3.1 ); VAS 0 - 3 ( mean: 0.5 ± 0.9 ); MAYO wrist scores 65 - 100 ( mean: 94.2 ± 10.0 ); grip strength ( 42.0 ± 4.4 ) kg on the injured side and ( 41.1 ± 2.8 ) kg on the contralateral side; TAM of the ring and little fingers ( 281 ± 3 ) °, ( 271 ± 6 ) ° on the injured side, while ( 283 ± 3 ) ° and ( 272 ± 4 ) ° on the contralateral side; No statistical differences in the grip strength and TAM between the two sides. Conclusions Coronal fractures of the hamate can be fixed with titanium miniplates crossing the carpometacarpal joints. This procedure can provide stability and allow early motion, which in turn helps maintain joint reduction and obtain good hand functions.
Keywords：Hamate boneFracturesboneFracture fixationinternalCarpal bones
Publication Date：2020-11-19
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 820-826 )