Isolated hook of hamate fracture in sports that require a strong grip comprehensive literature review

Abstract

Background: The aim of the study was to report characteristics of isolated hook of hamate fractures related to sports that require a strong grip and to identify factors affecting early diagnosis and recovery period.

Methods: A comprehensive literature search was conducted using MEDLINE, EMBASE, SCOPUS, Web of Science, the Cochrane Central Register of Controlled Trials, the World Health Organization International Clinical Trials Registry Platform, and the clinical trials registry and database of the US National Institutes of Health (ClinicalTrials.gov). There were no limits on the language or year of publication.This article included case reports and literature reviews for patients with isolated hook of hamate fractures related to sports that require a strong grip from 1977 to 2016.Two experienced reviewers extracted data from each study. The following data were extracted: sample size, patient's characteristics, cause of injury, injury side, time to diagnosis and symptoms, physical examination results, diagnostic work-up, treatment, complications, and recovery period.

Results: A total of 21 case reports and literature reviews with 120 patients satisfied our inclusion criteria. There was no significant difference in the time to diagnosis between the group before computed tomography (CT) was widely used and the group after CT was widely used. Recovery period showed a positive relationship with age (coefficient = 0.418, P < .01), time from injury to diagnosis or surgery (coefficient = 0.206, P < .05), and type of athlete (coefficient = 0.270, P < .01). On multiple stepwise regression analysis, recovery period was significantly associated with age (β = 0.418, P = .00), but not with time from injury to diagnosis or surgery.

Conclusions: Advance in diagnostic techniques does not guarantee early diagnosis of hook of hamate fractures. Strong suspicion of the disease with physical examination and carefully hearing patient's history are important for early diagnosis and management for patients with hook of hamate fractures.

Figure 1

Wrist PA/oblique view.

Figure 2

Bone scan. Left ulnar aspect of the distal carpus show increased uptake.

Figure 3

Wrist MRI showing hamate hook fracture in the left hand without evidence of TFCC injury. A, Sagittal T1-weighted image. B, Sagittal T2-weighted image. C, Axial T2-weighted image.

Figure 4

Classification of injured side of hands by causal sport (N = 85).

Figure 5

Initial subjective symptoms of patients with hook fractures (multiple answers were allowed, N = 120).

Figure 6

Physical examination findings (multiple answers were allowed, N = 120).

Figure 7

Number of cases detected by each diagnostic test (multiple tests were possible, N = 113).