HAMATE FRACTURES

Question 1

Anatomy of Guyon’s canal

Answer 1

Boundaries
1. Roof = superficial volar carpal ligament
2. Floor = transverse carpal ligament, hypothenar muscles
3. Radial border = hook of hamate
4. Ulnar border = pisiform, pisohamate ligament
Deep branch of ulnar nerve lies under hook of hamate

Question 2

Classification of hamate fractures

Answer 2

1. Hook of hamate fractures

2. Hamate body fractures

Question 3

Mechanism of injury for hamate fractures

Answer 3

1. Hook of hamate fractures
   - direct impact/ trauma
   - most common in athletes
2. Hamate body fractures
   - punch injuries
   - associated with base of 4th and 5th MC fractures or dislocations

Question 4

Best radiographic views for hamate fractures

Answer 4

1. Hook of hamate fractures = carpal tunnel view

2. Hamate body fractures = ER oblique view

Question 5

Complications associated with hook of hamate fractures

Answer 5

1. Ulnar nerve injury

2. Closed rupture of flexor tendons to LF