Dual Intra-Articular Fracture of the Body and Hook of Hamate: A Delayed Presentation

Abstract

Fractures of the hamate bone are an unusual clinical entity. Dual fractures involving both the body and the hook of the hamate are even more unique, with only two previous cases described in the literature, to our knowledge. Clinicians are often unfamiliar with the presenting signs of this unusual injury, and subsequently, diagnosis is often delayed or missed entirely. We describe the case of a 19-year-old male who sustained an intra-articular body of hamate fracture with an ipsilateral hook of hamate fracture in his dominant hand. He presented 10 days following the initial injury and was managed with open reduction and internal fixation (ORIF).

Figure 1

(a, b) X-ray right wrist PA and lateral views suggestive of a dual hamate fracture.

Figure 2

(a–c) CT images showing a longitudinal split fracture of both the hook and body of the hamate with 2 mm of dorsal displacement and intra-articular extension involving the CMC joint.

Figure 3

(a, b) Intraoperative screening showing satisfactory reduction and alignment of right dual hamate fracture using screw fixation and K-wire stabilisation to the 3^rd-5^th metacarpals.

Figure 4

(a, b) X-ray right hand PA and oblique 4 weeks postoperatively demonstrating satisfactory position, alignment, and evidence of healing.