유구골 골절의 수술적 치료

Abstract

Hamate fracture composes 2% of all carpal bone fracture, and it is classified to body and hook fracture. The prevalence of this fracture is increasing due to people's increasing involvement on the leisure sports. The diagnosis of this fracture requires detailed physical examination, plain radiography of both wrist, and carpal tunnel view. Also the CT scan or tomogram could be helpful for the diagnosis. The treatment can be enough with cast immobilization, if the fracture is not comminuted or there is no displacement. But, operative fixation is required in complicated cases because, nonunion or rough surface of the fracture can complicated to flexor tendon rupture, ulnar neuropathy, carpal tunnel syndrome, or traumatic arthritis. From July 1996 to February 1998, we operated 8 patients with hamate fracture. 7 patients were male and their age was from 21 to 68. Detailed physical examination and plain X-ray, carpal tunnel view was taken. CT scan or tomogram was performed for confirmation and operation. The initial symptom was pain in 6 patients, paresthesia and tingling sensation were other complaints. Confirmative image was carpal tunnel view in 3 cases, CT scan in 2 cases, tomogram in 1 case. Hook fracture was observed in 4 cases and body fracture was observed in 4 cases, which include 3 cases of coronal fracture. 4 cases were treated by percutaneous pinning followed by cast immobilization, 2 cases were treated by open reduction and internal fixation by mini screws. Excision and fusion was performed in other two cases.