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, 戴鲁飞, 郑炜, 等. 钩骨钩骨折的临床分型与治疗. 中华手外科杂志, 2011, 27(5): 269-272.
2.	陈振兵, 洪光祥, 王发斌. 钩骨钩部骨折四例报告及文献复习. 中华手外科杂志, 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.	杨勇, 武竞衡, 孙丽颖, 等. 微型钛板经腕掌关节固定治疗钩骨体冠状面骨折. 中华骨科杂志, 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. 腕关节疾病检查图解. 北京: 人民军医出版社, 2005: 106-108.
9.	郜永斌, 田光磊, 殷耀斌. 钩骨体部骨折的分型与治疗. 中国骨与关节杂志, 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.	杨晨光, 陈亮, 胡韶楠. 急性腕舟骨骨折的诊断治疗研究进展. 中国修复重建外科杂志, 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, 杨焕友, 等. 单纯钩骨钩骨折致尺神经深支损伤的临床研究. 中国骨与关节损伤杂志, 2012, 27(7): 598-600.
16.	李春江. 旋转加压张力带固定法治疗钩骨钩部骨折. 中华手外科杂志, 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, 范亚一, 等. 无头加压中空埋入螺钉内固定治疗肘关节内骨折的疗效. 中国修复重建外科杂志, 2019, 33(8): 986-990.

1. 熊革, 戴鲁飞, 郑炜, 等. 钩骨钩骨折的临床分型与治疗. 中华手外科杂志, 2011, 27(5): 269-272.
2. 陈振兵, 洪光祥, 王发斌. 钩骨钩部骨折四例报告及文献复习. 中华手外科杂志, 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. 杨勇, 武竞衡, 孙丽颖, 等. 微型钛板经腕掌关节固定治疗钩骨体冠状面骨折. 中华骨科杂志, 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. 腕关节疾病检查图解. 北京: 人民军医出版社, 2005: 106-108.
9. 郜永斌, 田光磊, 殷耀斌. 钩骨体部骨折的分型与治疗. 中国骨与关节杂志, 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. 杨晨光, 陈亮, 胡韶楠. 急性腕舟骨骨折的诊断治疗研究进展. 中国修复重建外科杂志, 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, 杨焕友, 等. 单纯钩骨钩骨折致尺神经深支损伤的临床研究. 中国骨与关节损伤杂志, 2012, 27(7): 598-600.
16. 李春江. 旋转加压张力带固定法治疗钩骨钩部骨折. 中华手外科杂志, 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, 范亚一, 等. 无头加压中空埋入螺钉内固定治疗肘关节内骨折的疗效. 中国修复重建外科杂志, 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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