Coronal Fracture of the Body of the Hamate

Fractures of the body of the hamate are unusual. Eleven patients with coronal fractures of the hamate bone, all involving dislocation of the hamate-metacarpal joint, are reported. Routine roentgenograms were not helpful in delineating the presence of the injury in five patients; therefore, fracture diagnosis was not initially made in those patients. The average delay in diagnosis of this group was 10 days. A 30-degree pronated view, tomograms, and computed tomography scans may be necessary in the diagnosis of this injury. This fracture was found to be highly unstable. Ten patients underwent surgery for stabilization of their fractures and restoration of the congruity of the hamate-metacarpal joint. Four patients were treated with open reduction and internal fixation of the fracture. Six patients were treated with closed reduction and percutaneous pinning. All patients treated surgically had maintenance of reduction of their joints. One patient was treated with closed reduction and casting; reduction in this case was lost, and the patient developed residual subluxation of the hamate-metacarpal joint.