Fractuur van een os hamatum en een os metacarpale

Background

Fractures of the hamate bone are rare, but are being seen more frequently due to the increasing popularity of racket sports and golf.

Case description

A 43-year-old man presented at our emergency department with a swollen, painful left hand after hitting a concrete wall with his fist. X-rays and CT scans revealed comminuted fracture of the hamate bone and the base of the fourth metacarpal bone. Open reduction and internal fixation, using screws and Kirschner wires, were performed. The postoperative course was uneventful. At one-year follow-up the patient had regained full use of his hand.

Conclusion

On conventional X-rays, 60% of wrist fractures are missed. If the clinical picture indicates a fracture of the hamate bone but conventional X-rays reveal no abnormalities then a supplementary CT-scan is advisable. Non-displaced fractures, or fractures with little displacement, can be treated conservatively, but surgical treatment is preferred in the case of displacement or non-union.

Conflict of interest: none declared. Financial support: none declared.