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Hamate Fracture Workup

  • Author: Amy Powell, MD; Chief Editor: Sherwin SW Ho, MD  more...
 
Updated: Oct 13, 2015
 

Laboratory Studies

See the list below:

  • Laboratory studies are not necessary for the diagnosis of hamate fractures.
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Imaging Studies

See the list below:

  • Radiographs: Fractures to the hamate may not be readily evident on radiographic images (see the images below).[9, 10] For this reason, multiple views of the wrist, including a carpal tunnel view, supination oblique view (hook of hamate view), and flexion and extension films, should be ordered. Even when appropriate radiographs are obtained, some studies demonstrate 72% sensitivity and 88% specificity for detecting hamate fractures.[10]
    Anteroposterior view of the wrist. Anteroposterior view of the wrist.
    Lateral view of the wrist. Lateral view of the wrist.
    Oblique view of the wrist. Oblique view of the wrist.
  • Computed tomography (CT) scan: In cases in which clinical findings suggest a fracture but the radiographic evidence is questionable, a CT scan should be ordered (see the images below).[9] CT scanning is considered the criterion standard, with sensitivity and specificity approaching 100%. In addition, this imaging modality determines the degree of fracture displacement, which aids in therapeutic decision making.
    Computed tomography scan of the wrist. Computed tomography scan of the wrist.
    Lateral computed tomography scan of the wrist. Lateral computed tomography scan of the wrist.
    Reconstruction of the hamate fracture. Reconstruction of the hamate fracture.
  • Magnetic resonance imaging (MRI): This study can be performed instead of CT scanning if the patient lacks neurologic and/or vascular competency in order to better view soft-tissue structures. Sensitivity and specificity approach 100% for diagnosing fractures.
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Contributor Information and Disclosures
Author

Amy Powell, MD Assistant Clinical Professor, Department of Orthopedics, University of Utah

Amy Powell, MD is a member of the following medical societies: American College of Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Janos P Ertl, MD Assistant Professor, Department of Orthopedic Surgery, Indiana University School of Medicine; Chief of Orthopedic Surgery, Wishard Hospital; Chief, Sports Medicine and Arthroscopy, Indiana University School of Medicine

Janos P Ertl, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, Hungarian Medical Association of America, Sierra Sacramento Valley Medical Society

Disclosure: Nothing to disclose.

Nancy J Taubenheim, DPT Staff Physical Therapist, Clinical Instructor, Department of Rehabilitation Services, Bryan LGH Medical Center

Disclosure: Nothing to disclose.

Warren S Theis, MD Staff Physician, Department of General Surgery, Carilion Roanoke Memorial Hospital

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Henry T Goitz, MD Academic Chair and Associate Director, Detroit Medical Center Sports Medicine Institute; Director, Education, Research, and Injury Prevention Center; Co-Director, Orthopaedic Sports Medicine Fellowship

Henry T Goitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine

Disclosure: Nothing to disclose.

Chief Editor

Sherwin SW Ho, MD Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago Division of the Biological Sciences, The Pritzker School of Medicine

Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, Arthroscopy Association of North America, Herodicus Society, American Orthopaedic Society for Sports Medicine

Disclosure: Received consulting fee from Biomet, Inc. for speaking and teaching; Received grant/research funds from Smith and Nephew for fellowship funding; Received grant/research funds from DJ Ortho for course funding; Received grant/research funds from Athletico Physical Therapy for course, research funding; Received royalty from Biomet, Inc. for consulting.

Additional Contributors

Gerard A Malanga, MD Founder and Partner, New Jersey Sports Medicine, LLC and New Jersey Regenerative Institute; Director of Research, Atlantic Health; Clinical Professor, Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey-New Jersey Medical School; Fellow, American College of Sports Medicine

Gerard A Malanga, MD is a member of the following medical societies: Alpha Omega Alpha, American Institute of Ultrasound in Medicine, North American Spine Society, International Spine Intervention Society, American Academy of Physical Medicine and Rehabilitation, American College of Sports Medicine

Disclosure: Received honoraria from Cephalon for speaking and teaching; Received honoraria from Endo for speaking and teaching; Received honoraria from Genzyme for speaking and teaching; Received honoraria from Prostakan for speaking and teaching; Received consulting fee from Pfizer for speaking and teaching.

Acknowledgements

Emily Harold, MD Staff Physician, Department of Internal Medicine, University of Utah Hospital

Disclosure: Nothing to disclose.

References
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Posterior (dorsal) view of the wrist.
Anterior palmar view.
Anteroposterior view of the wrist.
Lateral view of the wrist.
Oblique view of the wrist.
Computed tomography scan of the wrist.
Lateral computed tomography scan of the wrist.
Reconstruction of the hamate fracture.
 
 
 
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