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Hamate Body Fractures: a Comprehensive Review of the Literature

  • Distal Radius and Wrist Fractures (E Shin, Section Editor)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Purpose of Review

Due to the rarity and often discrete nature of hamate body fractures, timely diagnosis requires a high level of suspicion on the part of the clinician. Here, the authors have compiled the findings from 6 cohort studies and 33 case reports describing hamate body fractures in order to summarize the natural history, management, and outcomes of these infrequent injuries.

Recent Findings

Fractures of the hamate body typically occur in the coronal plane through axial loading of the metacarpals or loading in the transverse plane by a compressive force. Standard radiographs of the wrist frequently miss hamate fractures. Oblique and carpal tunnel views can be obtained when a fracture of the hamate is suspected. Advanced imaging with high-resolution computed tomography should also be considered if radiographs are negative and high suspicion for fracture remains or for the purpose of pre-operative planning. Co-existing injuries often include subluxation or dislocation of the 4th and 5th metacarpals with or without fracture. Non-displaced injuries that are stable may be treated non-operatively with immobilization. Displaced or unstable fracture patterns typically require closed reduction and percutaneous pinning versus open reduction internal fixation in order to restore anatomical alignment and maximize outcomes.

Summary

Hamate body fractures are uncommon fractures of the carpus. When appropriately treated, patients with hamate body fractures usually recover full pain-free range of motion and preserved grip strength. Complications are usually secondary to late presentation or noncompliance.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. El-shennawy M, Nakamura K, Patterson RM, Viegas SF. Three-dimensional kinematic analysis of the second through fifth carpometacarpal joints. J Hand Surg (American ed). United States: Elsevier BV. 2001;26:1030–5.

    Article  CAS  Google Scholar 

  2. Guyon F. Note sur une disposition anatomique propre a la face anterieure de la region du poignet et non encore decrite. Bull da la Soc Anat Paris. 1861;2nd Series:184–6.

  3. Shen L, Masih S, Patel DB, Matcuk GR. MR anatomy and pathology of the ulnar nerve involving the cubital tunnel and Guyon’s canal. Clin Imaging. United States: Elsevier Inc. 2015;40:263–74.

    Article  PubMed  Google Scholar 

  4. Bozkurt MC, Tağil SM, Özçakar L, Ersoy M, Tekdemir I. Anatomical variations as potential risk factors for ulnar tunnel syndrome: a cadaveric study: Anatomical Variations in Guyon’s Canal. Clin Anat. 2005;18:274–80.

    Article  PubMed  Google Scholar 

  5. Nakamura K, Patterson RM, Viegas SF. The ligament and skeletal anatomy of the second through fifth carpometacarpal joints and adjacent structures. J Hand Surg Am. Elsevier Inc. 2001;26:1016–29.

    Article  CAS  Google Scholar 

  6. Ebraheim NA, Skie MC, Savolaine ER, Jackson WT. Coronal fracture of the body of the hamate. Ebraheim NA, editor. J Trauma. 1995;38:169–74. Large cohort study that provides classification for hamate body fractures

    Article  CAS  PubMed  Google Scholar 

  7. Peters SJ, Verstappen C, Degreef I, De Smet L. Avascular necrosis of the hamate: three cases and review of the literature. J Wrist Surg. 333 Seventh Avenue, New York, NY 10001, USA: Thieme Medical Publishers. 2014;3:269–74.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Suh N, Ek ET, Wolfe SW. Carpal fractures. J Hand Surg Am. Elsevier Inc. 2014;39:785–91.

    Article  PubMed  Google Scholar 

  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. United States: Lippincott Williams & Wilkins, Inc. 1999;34:46–50. Cadaveric imaging study reveals the importance of the oblique radiograph and CT in diagnosis of hamate body fracture

  10. Cecava N, Finn M, Mansfield L. Subtle radiographic signs of hamate body fracture: a diagnosis not to miss in the emergency department. Emerg Radiol. Berlin/Heidelberg: Springer Berlin Heidelberg. 2017;24:689–95. Imaging study that defines 6 radiographic signs indicative of hamate body fracture

  11. Eder C, Scheller A, Schwab N, Krapohl BD. Hamate’s coronal fracture: diagnostic and therapeutic approaches based on a long-term follow-up. Eder C, editor. GMS Interdiscip Plast Reconstr Surg DGPW. 2019;8:Doc05–Doc05. Large cohort study tracking long-term outcomes associated with hamate body fracture

    Google Scholar 

  12. Zoltie N. Fractures of the body of the hamate. Injury. Netherlands: Elsevier Ltd. 1991;22:459–62.

    Article  CAS  PubMed  Google Scholar 

  13. Kim JK, Shin SJ. A novel hamatometacarpal fracture–dislocation classification system based on CT scan. Injury. Elsevier Ltd. 2012;43:1112–7. Fracture classification system based on preoperative imaging that determines fixation method

  14. Thomas AP, Birch R. An unusual hamate fracture. Hand. England. 1983;15:281–6.

    CAS  PubMed  Google Scholar 

  15. Cain JE, Shepler TR, Wilson MR. Hamatometacarpal fracture-dislocation: classification and treatment. J Hand Surg Am. Elsevier Inc. 1987;12:762–7. Large cohort study that describes fracture classification system involving subluxation of the 5th carpometacarpal joint

  16. Hirano K, Inoue G. Classification and treatment of hamate fractures. Hirano K, editor. Hand Surg. 2005;10:151–7. Large cohort study that provides fracture classification system for hamate body fractures

    Article  PubMed  Google Scholar 

  17. O’Shea MB, FRCSI K, Weiland MDAJ. Fractures of the hamate and pisiform bones. Hand Clin. United States: Elsevier Inc. 2012;28:287–300.

    Article  PubMed  Google Scholar 

  18. Albers-Schonberg. Isolierte fraktur (fissur) des os hamatum. Fortschr a d Gel, d Rontgenstrahlen. XIII.

  19. Milch H. Fracture of the hamate bone. J Bone Jt Surg. 1934;16:459–62.

    Google Scholar 

  20. Garcia-Elias M, Rossignani P, Cots M. Combined fracture of the hook of the hamate and palmar dislocation of the fifth carpometacarpal joint. J Hand Surgery, Br Vol. London, England: Elsevier Ltd. 1996;21:446–50.

    Article  CAS  Google Scholar 

  21. Ali MA. Fracture of the body of the hamate bone associated with compartment syndrome and dorsal decompression of the carpal tunnel. J Hand Surg Am. Scotland: Elsevier Ltd. 1986;11:207–10.

    Article  CAS  Google Scholar 

  22. Ha, Austin Y., Matthew Booth, and Mitchell A. Pet. "Two-incision Approach for the Open Reduction Internal Fixation of Intra-articular Hamate Body Fractures Using a Cannulated Headless Compression Screw." Techniques in hand & upper extremity surgery 24.4 2020;187–193.

  23. Austin RE, Pennings AL, ElMaraghy AW. Intraosseous fifth carpometacarpal dislocation associated with a coronal hamate fracture: a case report. JBJS case Connect. United States. 2014;4:e76.

    Article  PubMed  Google Scholar 

  24. Borse VH, Hahnel J, Faraj A. Lessons to be learned from a missed case of hamate fracture: a case report. J Orthop Surg Res. England: BioMed Central Ltd. 2010;5:64.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Boonstra RH, Snellen JP. A case of hamate fracture with dislocation of the ring and little finger metacarpals imaged with three-dimensional computed tomography. Eur J Trauma. Munich: Urban & Vogel. 2006;32:292–4.

    Article  Google Scholar 

  26. Brinkman JN, Hartholt KA, de Vries MR. Multiple carpometacarpal dislocations and an associated fracture of the hamate: an uncommon injury. BMJ Case Rep. England: BMJ Publishing Group LTD. 2016:bcr2015213106.

  27. Busche MN, Knobloch K, Rosenthal H, Vogt PM. Stress fracture of the hamate body and fourth metacarpal base following military style push-ups: an unusual trauma mechanism. Knee Surgery, Sport Traumatol Arthrosc. Berlin/Heidelberg: Springer-Verlag. 2008;16:1158–60.

    Article  Google Scholar 

  28. Chalmers RL, Kong KC. An unusual fracture of the hamate. J Hand Surg British Eur Vol. London, England: SAGE Publications. 2006;31:577–8.

    Article  CAS  Google Scholar 

  29. Fakih RR, Fraser AM, Pimpalnerkar AL. Hamate fracture with dislocation of the ring and little finger metacarpals. J Hand Surg Am. London, England: Elsevier Ltd. 1998;23:96–7.

    Article  CAS  Google Scholar 

  30. Gella S, Borse V, Rutten E. Coronal fractures of the hamate: are they rare or rarely spotted? J Hand Surg European Vol. London, England: SAGE Publications. 2007;32:721.

    Article  CAS  Google Scholar 

  31. Iwata N, Komura S, Hirakawa A, Kanamori S, Masuda T, Ito Y, et al. Dorsal buttress plate fixation for the treatment of fracture–dislocation of the fifth carpometacarpal joint with avulsion fracture of the hamate: a case report. Arch Orthop Trauma Surg. Berlin/Heidelberg: Springer Science and Business Media LLC. 2018;139:135–9.

    Article  PubMed  Google Scholar 

  32. Jones BG, Hems TE. Simultaneous fracture of the body of the hamate and the distal pole of the scaphoid. J Trauma. United States. 2001;50:568.

    Article  CAS  PubMed  Google Scholar 

  33. Jones RS, Kutty S. Intra-articular fractures of the hamate. Injury. Netherlands: Elsevier Ltd. 1993;24:272–3.

    Article  CAS  PubMed  Google Scholar 

  34. Kang S-Y, Song K-S, Lee H-J, Lee J-S, Park Y-B. A case report of coronal fractures through the hamate, the capitate, and the trapezoid. Arch Orthop Trauma Surg. Germany: Springer. 2009;129:963–5.

    Article  PubMed  Google Scholar 

  35. Kimura H, Kamura S, Akai M, Ohno T. An unusual coronal fracture of the body of the hamate bone. J Hand Surg Am. United States: Elsevier Inc. 1988;13:743–5.

    Article  CAS  PubMed  Google Scholar 

  36. Marck KW, Klasen HJ. Fracture-dislocation of the hamatometacarpal joint: a case report. J Hand Surg Am. United States: Elsevier Inc. 1986;11:128–30.

    Article  CAS  PubMed  Google Scholar 

  37. Nierkens CMH, van der Heijden BEPA. Simultaneous fracture dislocation of the hamate, lunate fracture and scapholunate ligament lesion. J Hand Surg European Vol. London, England: SAGE Publications. 2013;38:1005–6.

    Article  CAS  Google Scholar 

  38. Robison JE, Kaye JJ. Simultaneous fractures of the capitate and hamate in the coronal plane: case report. J Hand Surg Am. United States: Elsevier Inc. 2005;30:1153–5.

    Article  PubMed  Google Scholar 

  39. Roche S, Lenehan B, Street J. O'Sullivan M. Fourth metacarpal base fracture in association with coronal hamate fracture. Inj Extra. Elsevier Ltd. 2005;36:316–8.

    Article  Google Scholar 

  40. Salvador Marín J, Brotons Baile A, Cardona Vives N, Vargas Prieto JF, Pérez Alba JM, Martínez López JF. Fracture of the body’s hamate bone: open reduction internal fixation by double approach—a case report. Rev Iberoam Cirugía la Mano. Rio de Janeiro, Brazil: Thieme Revinter Publicações Ltda. 2018;46:126–30.

    Article  Google Scholar 

  41. Sullivan KL, Karasick D. Case report 397: fracture of the hamate in its coronal plane and dislocation of the hamate-triquetrum. Skeletal Radiol. Germany. 1986;15:593.

    Article  CAS  PubMed  Google Scholar 

  42. Terrono A, Ferenz CC, Nalebuff EA. Delayed diagnosis in non-union of the body of the hamate: a case report. J Hand Surg Am. Scotland: Elsevier Ltd. 1989;14:329–31.

    CAS  Google Scholar 

  43. Uhl RL, Campbell M. Hamate fracture-dislocation: a case report. J Hand Surg Am. United States: Elsevier Inc. 1995;20:578–80.

    Article  CAS  PubMed  Google Scholar 

  44. Van Schil P, De Smet C, Schoofs E. Fracture of the body of the hamate bone. Case report. Arch Orthop Trauma Surg. Germany. 1988;107:191–2.

    Article  PubMed  Google Scholar 

  45. Arora S, Goyal A, Mittal S, Singh A, Sural S, Dhal A. Combined intraarticular fracture of the body and the hook of hamate: an unusual injury pattern. J Hand Microsurg. India: Springer India. 2013;5:92–5.

    Article  PubMed  Google Scholar 

  46. Cano Gala C, Pescador Hernández D, Rendón Díaz DA, López 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. Netherlands: Elsevier Ltd. 2013;4:442–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Athanasiou V, Iliopoulos ID, Pantazis K, Panagopoulos A. Fracture of the body of the hamate with dorsal dislocation of the 4th and 5th metacarpals: a case report. Open Orthop J. Bentham Open. 2017;11:447–51.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Wharton DM, Casaletto JA, Choa R, Brown DJ. Outcome following coronal fractures of the hamate. J Hand Surg European Vol. London, England: SAGE Publications. 2010;35:146–9. Large cohort study with above average portion of patients treated nonoperatively

  49. Goliver BSJA, Adamow MDJS, Goliver J. Hamate body and capitate fracture in punch injury. Am J Emerg Med. United States: Elsevier Inc. 2014;32:1303.e1–2.

    Article  Google Scholar 

  50. O’Brien H, Paniker J. A painful swollen hand. BMJ. England. 2020;368:m614.

    Article  PubMed  Google Scholar 

  51. Roth JH, de Lorenzi C. Displaced intra-articular coronal fracture of the body of the hamate treated with a Herbert screw. J Hand Surg Am. United States: Elsevier Inc. 1988;13:619–21.

    Article  CAS  PubMed  Google Scholar 

  52. Bora FW, Didizian NH. The treatment of injuries to the carpometacarpal joint of the little finger. J Bone Joint Surg Am. United States: Copyright by The Journal of Bone and Joint Surgery, Incorporated. 1974;56:1459–63.

    Article  PubMed  Google Scholar 

  53. Gillespy T 3rd, Stork JJ, Dell PC. Dorsal fracture of the hamate: distinctive radiographic appearance. Am J Roentgenol. United States: Am Roentgen Ray Soc. 1988;151:351–3.

    Article  Google Scholar 

  54. Howard FM. Ulnar-nerve palsy in wrist fractures. J Bone Joint Surg Am. United States: Copyright by The Journal of Bone and Joint Surgery, Incorporated. 1961;43:1197–201.

    Article  PubMed  Google Scholar 

  55. Baird DB, Friedenberg ZB. Delayed ulnar-nerve palsy following a fracture of the hamate. J Bone Joint Surg Am. United States: Copyright by The Journal of Bone and Joint Surgery, Incorporated. 1968;50:570–2.

    Article  CAS  PubMed  Google Scholar 

  56. Gil JA, Goodman AD, Starr A. Coronal hamate fracture associated with carpometacarpal dislocations of all of the fingers: review of the literature and case report. HAND. Los Angeles, CA: SAGE Publications. 2017;12:NP51–4.

    Article  PubMed  Google Scholar 

  57. Moriya MDK, Saito MDH, Takahashi MDY, Ohi MDH. Divergent fracture–dislocation of the hamatometacarpal joint: case report. J Hand Surg Am. United States: Elsevier Inc. 2011;36:47–51.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Hand and Upper Extremity Surgery, Baylor College of Medicine, Houston, TX, USA

    M. Brent Price, Dallas Vanorny, Scott Mitchell & Chia Wu

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Correspondence to Chia Wu.

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This article is part of the Topical Collection on Distal Radius and Wrist Fractures

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Price, M.B., Vanorny, D., Mitchell, S. et al. Hamate Body Fractures: a Comprehensive Review of the Literature. Curr Rev Musculoskelet Med 14, 475–484 (2021). https://doi.org/10.1007/s12178-021-09731-6

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