Suk Ha Lee; Jong Wong Park; Jin Il Kim; Seoung Joon Lee

doi:10.12671/jkfs.2011.24.3.249

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Original Article
Operative Treatment in the Delayed Diagnosed Fracture and Dislocation of Hamatometacarpal Joint: Suk Ha Lee, M.D., Jong Wong Park, M.D., Jin Il Kim, M.D., Seoung Joon Lee, M.D.; Journal of the Korean Fracture Society 2011;24(3):249-255.
DOI: https://doi.org/10.12671/jkfs.2011.24.3.249
Published online: July 15, 2011

Department of Orthopedic Surgery, School of Medicine, Konkuk University, Seoul, Korea.

^*Department of Orthopedic Surgery, School of Medicine, Korea University, Seoul, Korea.

Address reprint requests to: Seoung Joon Lee, M.D. Department of Orthopaedic Surgery, Konkuk University School of Medicine, Hwayang-dong, Gwangjin-gu, Seoul 143-701, Korea. Tel: 82-2-2030-7360, Fax: 82-2-2030-7369, lsjmd@kku.ac.kr

• Received: May 19, 2010 • Revised: March 6, 2011 • Accepted: March 14, 2011

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Abstract
REFERENCES

Abstract

Purpose
The purpose is to evaluate and report the results that treated with open reduction and internal fixation in delayed diagnosed fracture and dislocation of the hamatometacarpal joint.
Materials and Methods
We evaluated 12 cases that had been treated with open reduction and internal fixation in delayed diagnosed fracture and dislocation of the hamatometacarpal joint. The mean interval between injury and operation was 34 days (21~60 days), the mean age of 12 cases was 28.1 years old, and mean follow-up period was 18 months. The computer tomography was done in all cases and the fracture and dislocation types were classified by Cain's classification. For the evaluation of results, pain scale, grasping power, range of motion of wrist and metacarpophalangeal joint were analyzed preoperatively and at final follow up, and the arthritic change of the hamatometacarpal joint was also checked.
Results
According to Cain's classification, type Ia was one case, type Ib was two, type II was six, and type III was three. The pain scale was improved from 7.75 preoperatively to 0.92 at last follow up. The mean grasping power was improved up to 97.5% of normal. The preoperative range of motion of the wrist joint measured to be 60 degrees in extension and 70 degrees in flexion; the final range of motion indicated to be 75 degrees in extension and 80 degrees in flexion. The preoperative range of motion of the metacarpophalangeal joint measured to be 0 degrees in extension and 70 degrees in flexion; the final range of motion indicated to be 0 degrees in extension and 85 degrees in flexion. Carpometacarpal arthritis was developed in two cases.
Conclusion
The open reduction and internal fixation is considered as one of good treatment option in the delayed diagnosed hamatometacarpal fracture and dislocation.
Key words: Hamatometacarpal joint, Fracture and dislocation, Open reduction and internal fixation

REFERENCES

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Fig. 1

Cain classification3).

Fig. 2

AP and lateral radiographs (A, B) and CT (C) scan show a fracture and dislocation of Cain's type II. AP and lateral radiographs (D, E) following operation of dorsal hamate fracture with 2.0 mm miniscrew and additional K-wire.

Fig. 3

AP and lateral radiographs (A, B) and CT (C) scan depicting a missed hamatometacarpal joint fracture and dislocation 30 days postinjury. AP and lateral radiographs (D, E) after operation. Final radiographs (F, G) show arthrosis at 4, 5th CMC joint.

Fig. 4

AP and lateral radiographs (A, B) and CT (C) scan depicting a missed hamatometacarpal joint fracture and dislocation 25 days postinjury.

Table 1

Details of the patient

Table 2

Results of the last follow-up

Figure & Data

REFERENCES

Citations

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J. H. Kim, S.-S. Kwon, S. J. Moon, J. S. Choe, H. I. Kwak, S. Y. Lee, H. J. Le, J. Y. Kim
Journal of Hand Surgery (European Volume).2016; 41(4): 448. CrossRef
Fourth and Fifth Metacarpal Base Arthrodesis for Posttraumatic Arthritis of Fifth Carpometacarpal Joint
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Journal of the Korean Society for Surgery of the Hand.2013; 18(4): 184. CrossRef

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Operative Treatment in the Delayed Diagnosed Fracture and Dislocation of Hamatometacarpal Joint

J Korean Fract Soc. 2011;24(3):249-255. Published online July 31, 2011

DOI: https://doi.org/10.12671/jkfs.2011.24.3.249

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Operative Treatment in the Delayed Diagnosed Fracture and Dislocation of Hamatometacarpal Joint

Fig. 1 Cain classification3).

Fig. 2 AP and lateral radiographs (A, B) and CT (C) scan show a fracture and dislocation of Cain's type II. AP and lateral radiographs (D, E) following operation of dorsal hamate fracture with 2.0 mm miniscrew and additional K-wire.

Fig. 3 AP and lateral radiographs (A, B) and CT (C) scan depicting a missed hamatometacarpal joint fracture and dislocation 30 days postinjury. AP and lateral radiographs (D, E) after operation. Final radiographs (F, G) show arthrosis at 4, 5th CMC joint.

Fig. 4 AP and lateral radiographs (A, B) and CT (C) scan depicting a missed hamatometacarpal joint fracture and dislocation 25 days postinjury.

Fig. 1

Fig. 2

Fig. 3

Fig. 4

Operative Treatment in the Delayed Diagnosed Fracture and Dislocation of Hamatometacarpal Joint

Table 1

Details of the patient

Table 2

Results of the last follow-up

Table 1 Details of the patient

Table 2 Results of the last follow-up