Hamate Fracture Workup

Updated: Aug 06, 2018
  • Author: Amy Powell, MD; Chief Editor: Sherwin SW Ho, MD  more...
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Workup

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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