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Kwon TY, Lee YK. Multiple flexor tendon ruptures due to osteochondroma of the hamate: A case report. World J Clin Cases 2023; 11:3038-3044. [PMID: 37215430 PMCID: PMC10198070 DOI: 10.12998/wjcc.v11.i13.3038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/19/2023] [Accepted: 04/04/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Closed rupture of the little and ring finger flexor tendons caused by the hamate is mostly associated with a fracture or nonunion of the hamate hook. Only one case of a closed rupture of the finger flexor tendon caused by osteochondroma in the hamate has been reported. Here, we present a case study to highlight the possibility of hamate osteochondroma as a rare cause of finger closed flexor tendon rupture based on our clinical experience and literature review.
CASE SUMMARY A 48-year-old man who had been a rice-field farmer for 7–8 h a day for the past 30 years visited our clinic due to the loss of right little finger and ring finger flexion involving both the proximal and distal interphalangeal joints. The patient was diagnosed with a complete rupture of the ring and little finger flexors because of the hamate and was pathologically diagnosed with an osteochondroma. Exploratory surgery was performed, and a complete rupture of the ring and little finger flexors due to an osteophyte-like lesion of the hamate was observed, which was pathologically diagnosed as an osteochondroma.
CONCLUSION One should consider that osteochondroma in the hamate may be the cause of closed tendon ruptures.
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Affiliation(s)
- Tae Young Kwon
- Department of Orthopedics, Jeonbuk National University Hospital, Jeonju-si 54907, South Korea
| | - Young-Keun Lee
- Department of Orthopedic Surgery, Research Institute of Clinical Medicine of Jeonbuk National University – Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju 54896, South Korea
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2
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Kimura H, Sato K, Suzuki T, Matsumura N, Iwamoto T. Excision of the hook of hamate in athletes using the carpal tunnel approach. J Orthop Sci 2023; 28:143-146. [PMID: 34785120 DOI: 10.1016/j.jos.2021.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/19/2021] [Accepted: 10/26/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Hook of the hamate fractures can be managed conservatively or fixed using a screw, but excision is recommended for prompt return to activities. Although various approaches have been described, there is no gold standard. Herein, the authors have described their clinical experiences in excising the hook of the hamate using the carpal tunnel approach, in athletes. METHODS A total of 36 athletes underwent excision of the hamate hook using the carpal tunnel approach. The mean age of the patients was 23 years, and most of them were baseball players (n = 31). RESULTS The mean operation time was 33 min. None of the patients presented with any complications aside from transient pillar pain in five cases. All of them returned to their sports activities within an average of 27 days. CONCLUSIONS In our study, excision of the hook of the hamate was performed safely via the carpal tunnel. The carpal tunnel approach reportedly provides superior benefits over other approaches.
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Affiliation(s)
- Hiroo Kimura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.
| | - Kazuki Sato
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan.
| | - Taku Suzuki
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.
| | - Noboru Matsumura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.
| | - Takuji Iwamoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.
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3
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Kuroda T, Moriya K, Tsubokawa N, Maki Y, Inagaki K, Yoshizu T. Comparison of bridge graft and end-to-side transfer for treatment of closed rupture of the flexor tendons in the little finger. J Hand Surg Eur Vol 2022; 47:520-526. [PMID: 35086366 DOI: 10.1177/17531934211073751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The purpose of this study was to compare the outcomes of bridge tendon grafts and end-to-side tendon transfers for treating closed ruptures of the flexor tendons in Zones 3 to 5 of the little finger. We selected the surgical procedure based on the passive distraction amplitude of the proximal part of the ruptured flexor tendon. Eleven patients comprised the bridge tendon graft group and ten patients comprised the end-to-side tendon transfer group. We found no significant between-group differences in the total active motion, percentage of total active motion, functional assessment by the Strickland and Glogovac criteria and grip strength compared with the unaffected hand. We believe that choosing the surgical procedure after determining the passive distraction amplitude of the ruptured tendon can be useful in clinical practice.Level of evidence: III.
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Affiliation(s)
- Takuma Kuroda
- Niigata Hand Surgery Foundation, Niigata, Japan.,Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Koji Moriya
- Niigata Hand Surgery Foundation, Niigata, Japan
| | | | - Yutaka Maki
- Niigata Hand Surgery Foundation, Niigata, Japan
| | - Katsunori Inagaki
- Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo, Japan
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4
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Engler ID, Barrazueta G, Colacchio ND, Ruchelsman DE, Belsky MR, Leibman MD. Excision of Hook of Hamate Fractures in Elite Baseball Players: Surgical Technique and Return to Play. Orthop J Sports Med 2022; 10:23259671211038028. [PMID: 35368440 PMCID: PMC8972935 DOI: 10.1177/23259671211038028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 05/19/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Hook of hamate fractures are relatively common in baseball players, but the proper diagnosis and surgical technique can be challenging. Outcomes after surgical excision, as well as optimal surgical technique, in elite baseball players have not been clearly established. Hypothesis: Excision of hook of hamate fractures with a technique tailored to elite professional and collegiate baseball players will lead to high rates of return to play within a short time. Study Design: Case series; Level of evidence, 4. Methods: We reviewed the cases of 42 elite athletes who underwent surgical excision of 42 hook of hamate fractures at a single academic hand surgery practice from 2006 to 2020. The athletes competed at the professional (n = 20) or varsity collegiate (n = 22) baseball levels and were treated using the same surgical technique tailored toward the elite athlete. The clinical history, timing of surgery, complications, and time to return to play were recorded for each patient. Results: All 42 patients underwent an excision of their hook of hamate fracture at a mean of 7.2 weeks (range, 0.5-52 weeks) from the onset of symptoms. All but one patient were able to return to full preinjury level of baseball participation within 6 weeks from the date of surgery, with a mean return to sport of 5.4 weeks (range, 3-8 weeks). Two patients returned to the operating room—1 for scar tissue formation causing ulnar nerve compression and 1 for residual bone fragment causing pain and ulnar nerve compression. Conclusion: Surgical excision of hook of hamate fractures in elite baseball players showed a very high rate of return to play within 6 weeks. Meticulous adherence to the described surgical technique tailored to athletes optimizes clinical outcomes and avoids complications.
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Affiliation(s)
- Ian D. Engler
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
- Ian D. Engler, MD, UPMC Freddie Fu Center, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 3200 South Water St, Pittsburgh, PA, USA ()
| | - Gustavo Barrazueta
- Department of Orthopaedics, Tufts Medical Center, Boston, Massachusetts, USA
| | | | - David E. Ruchelsman
- Department of Orthopaedic Surgery, Tufts University School of Medicine, Boston, Massachusetts, USA
- Hand Surgery PC, Newton, Massachusetts, USA
| | - Mark R. Belsky
- Department of Orthopaedic Surgery, Tufts University School of Medicine, Boston, Massachusetts, USA
- Hand Surgery PC, Newton, Massachusetts, USA
| | - Matthew D. Leibman
- Department of Orthopaedic Surgery, Tufts University School of Medicine, Boston, Massachusetts, USA
- Hand Surgery PC, Newton, Massachusetts, USA
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5
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Hatori Y, Tajika T, Kuboi T, Saida R, Chikuda H. Closed rupture of a flexor profundus tendon to the little finger caused by asymptomatic pisotriquetral osteoarthritis: A case required differentiation from the tendon rupture due to hamate bony irregularity by bone erosion. SAGE Open Med Case Rep 2022; 10:2050313X221104314. [PMID: 35747244 PMCID: PMC9210073 DOI: 10.1177/2050313x221104314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 05/06/2022] [Indexed: 11/29/2022] Open
Abstract
Carpal joint osteoarthritis and the formation of bony irregularities of the carpal bone cause closed flexor tendon ruptures. This report describes a case of a flexor profundus tendon closed rupture of the little finger due to asymptomatic pisotriquetral osteoarthritis in a 73-year-old woman, which required differentiation from tendon rupture due to hamate bony irregularity due to bone erosion. Computed tomography showed cortical bone irregularities of the hamate and the narrowing of the pisotriquetral joint space, and a bony spur on the radial side of the pisiform. Intraoperative findings revealed the capsule of the pisotriquetral joint was torn on the radial side. Pisiform-hamate ligament disruption and the bony spur on the pisiform were found on this side. However, the flexor tendon floor on the hamate was intact. Surgical resection of the pisiform and a free tendon interposition graft for tendon rupture restored the good function of the little finger. Particular attention should be paid in making the diagnosis in cases with multiple possible triggers for closed flexor tendon rupture.
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Affiliation(s)
- Yuhei Hatori
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Tsuyoshi Tajika
- Graduate School of Health Sciences, Gunma University, Maebashi, Gunma, Japan
| | - Takuro Kuboi
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Ryuta Saida
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Hirotaka Chikuda
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
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Abstract
Hook of hamate fractures are uncommon injuries with unclear prevalence. Classic presenting symptoms include volar-ulnar hand/wrist pain and weakness in grip, with possible ulnar nerve paresthesias. Patient factors, such as activity level and desired return to work/sport, shape the most appropriate treatment regimen although excision of the hook has been adopted by most surgeons. Overall, once patients receive the correct diagnosis and are treated, good outcomes with high satisfaction rates are expected.
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Affiliation(s)
- Andrea Tian
- Department of Orthopaedic Surgery, Washington University, 660 South Euclid Avenue, Campus Box 8233, St Louis, MO 63110, USA
| | - Charles A Goldfarb
- Department of Orthopaedic Surgery, Washington University, 660 South Euclid Avenue, Campus Box 8233, St Louis, MO 63110, USA.
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Kuroda T, Moriya K, Tsubokawa N, Narisawa H, Maki Y, Inagaki K, Yoshizu T. Wide-Awake Approach for Flexor Digitorum Superficialis Tendon Transfer Followed by Early Active Mobilization. Indian J Plast Surg 2021; 54:338-343. [PMID: 34667521 PMCID: PMC8515314 DOI: 10.1055/s-0041-1734577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Background The standard clinical practice to treat closed ruptures of the flexor digitorum profundus (FDP) tendons includes free tendon grafting; however, it is not suitable when the muscle amplitude of the ruptured FDP is not sufficient. We report outcomes of six patients who underwent flexor digitorum superficialis (FDS) tendon transfer of the ring finger using the wide-awake approach to repair the closed rupture of the FDP tendon of the little finger in zone 3 or 4. Methods The patients were identified by reviewing our institutional billing records from January 2012 to October 2019 for the International Classification of Disease 10 code M66.3 that describes the diagnosis as "spontaneous rupture of flexor tendons." Results The patients comprised two men and four women with an average age of 72.2 years (standard deviation [SD], 8.4 years). All patients were hospitalized after surgery to undergo early active mobilization. The average total active motion at the final evaluation was 201.8° (range: 85-248°). According to Strickland's criteria, outcomes were excellent for two, good for three, and poor for one patient. No patients complained about the ring finger. Conclusion These results suggest that FDS tendon transfer is recommended when the muscle amplitude of the ruptured FDP is insufficient. We believe that the wide-awake approach and early active mobilization may contribute to satisfactory outcomes.
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Affiliation(s)
- Takuma Kuroda
- Niigata Hand Surgery Foundation, Niigata, Japan.,Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Koji Moriya
- Niigata Hand Surgery Foundation, Niigata, Japan
| | | | | | - Yutaka Maki
- Niigata Hand Surgery Foundation, Niigata, Japan
| | - Katsunori Inagaki
- Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo, Japan
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Tedesco LJ, Swindell HW, Anderson FL, Jang E, Wong TT, Kazam JK, Kadiyala RK, Popkin CA. Evaluation and Management of Hand, Wrist and Elbow Injuries in Ice Hockey. Open Access J Sports Med 2020; 11:93-103. [PMID: 32425621 PMCID: PMC7196194 DOI: 10.2147/oajsm.s246414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 03/12/2020] [Indexed: 12/01/2022] Open
Abstract
Ice hockey continues to be a popular, fast-paced, contact sport enjoyed internationally. Due to the physicality of the game, players are at a higher risk of injury. In the 2010 Winter Olympics, men’s ice hockey had the highest injury rate compared to any other sport. In this review, we present a comprehensive analysis of evaluation and management strategies of common hand, wrist, and elbow injuries in ice hockey players. Future reseach focusing on the incidence and outcomes of these hand, wrist and elbow injuries in ice hockey players is warranted.
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Affiliation(s)
- Liana J Tedesco
- Center for Shoulder, Elbow and Sports Medicine, Columbia University Medical Center, New York, NY, USA
| | - Hasani W Swindell
- Center for Shoulder, Elbow and Sports Medicine, Columbia University Medical Center, New York, NY, USA
| | - Forrest L Anderson
- Center for Shoulder, Elbow and Sports Medicine, Columbia University Medical Center, New York, NY, USA
| | - Eugene Jang
- Center for Shoulder, Elbow and Sports Medicine, Columbia University Medical Center, New York, NY, USA
| | - Tony T Wong
- Department of Radiology, New York Presbyterian Hospital, New York, NY, USA
| | - Jonathan K Kazam
- Department of Radiology, New York Presbyterian Hospital, New York, NY, USA
| | - R Kumar Kadiyala
- Department of Orthopedic Surgery, Columbia University Medical Center, New York, NY, USA
| | - Charles A Popkin
- Center for Shoulder, Elbow and Sports Medicine, Columbia University Medical Center, New York, NY, USA
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9
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Abstract
BACKGROUND The angiography with micro-computed tomography (micro-CT) has been proved its great advantages on investigating the intra-osseous vascularity of carpal bones. But few researches have focused on the intra-hamate vascularity. This study aimed to illustrate the intra-osseous arteries of the hamate and the relationship between the intra-hamate vascularity and the avascular risk of different types of hamate fractures. METHODS Six normal cadaveric hamates were investigated with red lead (Pb3O4) micro-CT angiography. The intra-osseous arteries of specimens were clearly enhanced and the three-dimensional model was reconstructed. In order to study the features of the arterial entrances and intra-hamate vascularity, the diameters, quantities, locations of enhanced arteries, and the locations of transversal/proximal pole fracture lines on the body of the hamate were statistically compared. Besides, in order to analyze the relationship between intra-hamate vascularities and different hamate fractures, 127 cases of hamate fractures who presented in our hospital from March 2003 to June 2017 were retrospectively studied. RESULTS A total of 94 cases were followed up (range: 4-37 months; mean: 12.4 months) effectively. The overall union rate of hamate fractures was as high as 92.6% (87 of 94 cases), while non-union of fracture on hamate hook was more common (P = 0.031). The arterial entrances were located around the dorsal, volar, radial, ulnar non-articular surfaces of the hamate body and the hook of the hamate. Generally, there were one to two trunk arteries on the volar non-articular surface and one to three trunk arteries on the dorsal non-articular surface. They formed one or two arterial arches, from which some branches were emitted and supplied the proximal parts. The intra-osseous vascularities of the hamate body were generally located in the radial part. The blood supply of the hook was mainly from the volar non-articular surface in most specimens. Hamate fractures could be classified into four types: fractures of the transversal/proximal pole, medial tuberosity, dorsal coronal of the hamate body, and fractures of the hamate hook. CONCLUSIONS This study showed new features of intra-hamate vascularity and the results will guide surgeons to reduce the vascular damage during the hamate fracture operations. The fracture lines of different types of hamate fractures may disrupt the intra-hamate arteries. The intra-hamate vascularities will have different influences on the avascular risks of different hamate fractures.
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Affiliation(s)
- Zi-Run Xiao
- Department of Hand Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Wei-Guang Zhang
- Department of Anatomy and Histology, Peking University Health Science Center, Beijing 100191, China
| | - Ge Xiong
- Department of Hand Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
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10
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Gonera B, Kurtys K, Karauda P, Olewnik Ł, Polguj M. Possible effect of morphological variations of plantaris muscle tendon on harvesting at reconstruction surgery-case report. Surg Radiol Anat 2020; 42:1183-1188. [PMID: 32248255 PMCID: PMC7366566 DOI: 10.1007/s00276-020-02463-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 03/23/2020] [Indexed: 01/11/2023]
Abstract
Purpose Seemingly a well-known, weak, and vestigial plantaris muscle should not be a revelation. However, recent studies have shown that this structure is incredibly underestimated and perceived only as an infirm flexor of the talocrural joint, the knee joint or a great source of graft tissue. Usually, the origin of this inconspicuous muscle begins at the lateral supracondylar line of the femur and the knee joint capsule. It continues distally, forming a long and slender tendon. In most cases, it inserts onto the calcaneal tuberosity on the medial side of the Achilles tendon. However, many morphological variations have been discovered during anatomical dissections and surgical procedures. Nevertheless, according to the present literature, no other studies presented such a complex insertion variant, with indisputable clinical value and significant proof of development of this forgotten muscle. Methods The dissection of the right thigh, knee, crural and talocrural region was performed using standard techniques according to a strictly specified protocol. Results Four different insertion points were observed. The first band (A) inserted near to the tarsal canal flexor retinaculum. The second band (B) bifurcates into two branches—B1 and B2. B1 is located on the medial side and B2 is located on the lateral side of the calcaneal tuberosity. The third band (C) is inserted into the superior nonarticular calcaneal surface of the calcaneus anteriorly to the Achilles tendon. Conclusion A differently shaped plantaris tendon could be considered a cause of harvesting procedure failure. In the light of new case reports perhaps what we are now witnessing is remodeling and transformation of the Plantaris muscle. If so, the awareness of the influence on the onset of Achilles midportion tendinopathy or a potential role in tibialis posterior conflict can be crucial for every clinician.
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Affiliation(s)
- B Gonera
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Mechaniczna 5a, 92-310, Lodz, Poland.
| | - K Kurtys
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Mechaniczna 5a, 92-310, Lodz, Poland
| | - P Karauda
- Department of Normal and Clinical Anatomy, Medical University of Lodz, Lodz, Poland
| | - Ł Olewnik
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Mechaniczna 5a, 92-310, Lodz, Poland
| | - M Polguj
- Department of Normal and Clinical Anatomy, Medical University of Lodz, Lodz, Poland
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11
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Takeda S, Tatebe M, Ishii H, Morita A, Wakai K, Hirata H. Computerized tomographic prediction of flexor tendon injuries complicating hamate hook fractures. J Hand Surg Eur Vol 2019; 44:367-371. [PMID: 30674228 DOI: 10.1177/1753193418823503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We reviewed computerized axial tomography of 28 patients with hamate hook fractures who had surgical resection of the hook. We analysed the relationship between the fragment height ratio, fragment gap, and intraoperative findings of the tendons. We determined whether parameters in the images can predict complication of tear or disruption of the flexor tendons to the ring or little fingers. Of 28 patients, 16 had fragment height ratios between 50-74; ten among them had worn (eight patients) or ruptured (two patients) flexor tendons. Nine of the ten patients had fragment gaps greater than 2 mm. The remaining 12 patients had fragment height ratios between 75-100 and had intact tendons. We conclude that a fragment height ratio greater than 75 and fragment gap less than 2 mm in computer tomography may rule out tear or disruption of the flexor tendons of the ring and little fingers after hamate hook fractures, and a fragment height ratio between 50-74 with fragment gap greater than 2 mm indicates a high risk of flexor tendon tear or disruption. Level of evidence: IV.
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Affiliation(s)
- Shinsuke Takeda
- 1 Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.,2 Hand and Microsurgery Center, Anjo Kosei Hospital, Anjo, Aichi, Japan
| | - Masahiro Tatebe
- 1 Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hisao Ishii
- 1 Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akimasa Morita
- 3 Department of Orthopaedic Surgery, Suzuka Kaisei Hospital, Suzuka, Mie, Japan
| | - Kenji Wakai
- 4 Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hitoshi Hirata
- 1 Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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12
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Abstract
Background: The tendon of the plantaris muscle (PM) is highly relevant in surgical practice. It is used as a graft for tendon/ligament repair or reconstruction in hand surgery whenever palmaris longus (PL) is lacking. Its occurrence in humans is reported to be high. Methods: A meta-analysis based on cadaveric studies was conducted to quantitatively assess PM frequency and size. Results: Data from 41 studies including 10062 leg specimens yielded the following: overall true prevalence ≈ 93%, overall crude prevalence = 90.6%, bilateral prevalence ≈ 92%, significantly more frequent on the right side, no gender significance, and no significant differences between ethnicities except that of Brazilian populations. The pooled mean length (± SD) of the PM tendon (PT) was 30.63 ± 5.87 cm and that of its width was 3.68 ± 1.37 mm. Pooled frequencies of the types of PT insertion are reported. Conclusions: This meta-analysis demonstrated a higher prevalence of PM when compared to clinical PL frequency in the literature with a tendon length double than that of PL along with an acceptable width. The surgical availability of the PM tendon was found stable across human populations; a clinical advantage when compared to the high variability of PL ethnicity-based frequency. Our results indicate that the PT is of high clinical relevance as a reliable and suitable resource for tendon grafting and reconstruction.
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Affiliation(s)
- Kaissar Yammine
- Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Achrafieh, Lebanon
- Center for Evidence-Based Anatomy, Sports & Orthopedic Research, Jdeideh, Lebanon
| | - Said Saghie
- Department of Orthopedic Surgery, American University of Beirut, Beirut, Lebanon
| | - Chahine Assi
- Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Achrafieh, Lebanon
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13
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Goto K, Naito K, Sugiyama Y, Nagura N, Kaneko A, Iwase Y, Kaneko K. Sliding Position of the Flexor Tendons Relative to the Hook of Hamate in CT Scans. J Hand Surg Asian Pac Vol 2019; 24:72-75. [PMID: 30760158 DOI: 10.1142/s2424835519500139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The aim of this study was to assess the height of nonunion formation injuring the ulnar-side finger flexor tendon, the positional relationship between the hook of the hamate and little finger flexor tendon was evaluated on CT scans. METHODS The subjects were 20 healthy patients (40 hands) (14 males and 6 females, mean age: 28 years old). Their hands were imaged in extension and flexion of the fingers on CT. The position of the little finger flexor tendon was determined regarding the height of the hook of the hamate as 100%. RESULTS The heights of the flexor digitorum profundus tendons were 46 ± 6% in extension and 44 ± 9% in flexion, and those of the flexor digitorum superficialis tendons were 87 ± 8% in extension and 91 ± 9% in flexion. CONCLUSIONS Our study suggested that 40% of the base of the hook of the hamate does not contact with the flexor tendon, suggesting that flexor tendon injury is unlikely to occur in that region.
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Affiliation(s)
- Kenji Goto
- * Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan
| | - Kiyohito Naito
- * Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan
| | - Yoichi Sugiyama
- * Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan
| | - Nana Nagura
- * Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan.,† Department of Orthopaedic Surgery, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Ayaka Kaneko
- * Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan
| | - Yoshiyuki Iwase
- † Department of Orthopaedic Surgery, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Kazuo Kaneko
- * Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan
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14
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Abstract
Injuries to the hands and wrist are common in athletes. Injuries include acute fractures, dislocations, ligamentous, and tendon injuries, as well as more chronic injuries such as sprains and strains. Complications in the treatment of sports injuries of the hand and wrist may be divided into 2 categories: incorrect or delayed diagnosis and iatrogenic injury related to treatment. This article highlights common sports injuries of the hand and wrist and their complications, and includes tips for successful management.
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Affiliation(s)
- Nicholas Pulos
- Department of Orthopedic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA
| | - Sanjeev Kakar
- Department of Orthopedic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA.
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15
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Kim YJ, Baek JH, Park JS, Lee JH. Interposition Tendon Graft and Tension in the Repair of Closed Rupture of the Flexor Digitorum Profundus in Zone III or IV. Ann Plast Surg 2018; 80:238-41. [PMID: 29095192 DOI: 10.1097/SAP.0000000000001240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We report the results of interposition tendon grafts using the ipsilateral palmaris longus tendon in 12 patients with closed flexor digitorum profundus tendon ruptures in zone III or IV of 14 digits between June 2006 and October 2015. Before surgery, 2 patients were diagnosed with closed tendon ruptures that occurred after nonunion of hamate hook fractures. The other 10 patients were diagnosed with spontaneous tendon ruptures of unknown cause. In 2 of the 10 patients with spontaneous tendon rupture, the cause of the rupture was not found. In the other 8 patients, there was rough surface with deficient overlying soft tissue on the radial side of the hamate hook. In all cases, the ruptured flexor digitorum profundus was reconstructed by applying overtension on the tendon graft, causing greater flexion than for the other normal digits. Hamate hook excision was also performed on 10 subjects with abnormalities. Postoperatively, the patients were followed for an average of 22.5 months (range, 12-64 months). At the final follow-up, the mean Disabilities of the Arm, Shoulder, and Hand questionnaire score was 5.7 (range, 3.3-8.3). There were excellent results in all 14 digits according to Strickland and Glogovac criteria. The mean total active motion was 167 degrees (range, 160-180 degrees). There were no surgical complications, including infection, adhesions, or tendon rerupture. There were excellent clinical results with the interposition tendon graft using palmaris longus for closed tendon rupture in zone III or IV of the hand. Applying overtension to the grafted tendon appears to be beneficial.
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Abstract
A thorough understanding of the swing phases and mechanisms of injury in golf allows accurate diagnosis, treatment, and future prevention of injuries. Recommended initial treatment starts with cessation of practice to rest the wrist, a splint or orthotic brace, and nonsteroidal antiinflammatory drug medication with corticosteroid injection and swing modification. Pisiform excision is the best treatment of the most severe chronic cases of pisiform ligament complex syndrome. Delayed diagnosis of hook of hamate fracture may lead to complications, including flexor tendon rupture. Prompt surgical resection is recommended to hasten return to sport and to prevent further complications.
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Affiliation(s)
- Sang-Hyun Woo
- W Institute for Hand and Reconstructive Microsurgery, W Hospital, 1632 Dalgubeol-daero, Dalseo-Gu, Daegu 42642, Korea
| | - Young-Keun Lee
- Department of Orthopaedic Surgery, Chonbuk National University Hospital, 93, Changpo-gil, Deokjin-gu, Jeonju, Jeollabuk-do 54896, Korea.
| | - Jong-Min Kim
- W Institute for Hand and Reconstructive Microsurgery, W Hospital, 1632 Dalgubeol-daero, Dalseo-Gu, Daegu 42642, Korea
| | - Ho-Jun Cheon
- W Institute for Hand and Reconstructive Microsurgery, W Hospital, 1632 Dalgubeol-daero, Dalseo-Gu, Daegu 42642, Korea
| | - William H J Chung
- Comprehensive Hand Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Road, Building 14 G200, Ann Arbor, MI 48109, USA
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Yamazaki H, Uchiyama S, Hosaka M, Kato H. Closed Rupture of the Flexor Tendon Secondary to Sclerosis of the Hook of the Hamate: A Report of Two Cases. J Hand Surg Asian Pac Vol 2016; 21:405-9. [PMID: 27595962 DOI: 10.1142/s2424835516720164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Closed flexor tendon ruptures in the little finger can be caused by fracture or nonunion of the hook of the hamate, but no case of the disorder secondary to the sclerosis and thinning of the hamate hook has been reported. We report two rare cases with this complication due to rough surface of the hamate hook. Carpal tunnel view radiographs and computed tomography showed the sclerosis and thinning of the hook.
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Affiliation(s)
- Hiroshi Yamazaki
- * Department of Orthopaedic Surgery, Aizawa Hospital, Matsumoto, Japan
| | | | - Masato Hosaka
- * Department of Orthopaedic Surgery, Aizawa Hospital, Matsumoto, Japan
| | - Hiroyuki Kato
- * Department of Orthopaedic Surgery, Aizawa Hospital, Matsumoto, Japan
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Abstract
Fractures of the hand are frequently encountered with injuries to the phalanges and metacarpals comprising the vast majority. Fractures of the carpal bones excluding the scaphoid, however, are fairly uncommon. Despite the rarity of fractures of the remaining seven carpal bones, they can cause a disproportionate amount of morbidity from missed diagnosis due to their subtlety as well as their frequent association with significant ligamentous disruption or even other carpal bone fractures. Delayed diagnosis can result in inadequate fracture care, which places the wrist at risk of disabling sequelae. This review focuses on the current concepts of pathophysiology, diagnosis, and treatment of carpal fractures other than the scaphoid.
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Affiliation(s)
- T Pan
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 3471 Fifth Avenue, Pittsburgh, PA, USA.
| | - T T Lögters
- Department of Trauma and Hand Surgery, University Hospital Duesseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - J Windolf
- Department of Trauma and Hand Surgery, University Hospital Duesseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - R Kaufmann
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 3471 Fifth Avenue, Pittsburgh, PA, USA
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20
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Condés JS, Martínez LI, Carrasco MS, Julia FC, Martínez ES. Hamate fractures. Rev Esp Cir Ortop Traumatol (Engl Ed) 2015; 59:299-306. [DOI: 10.1016/j.recote.2015.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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21
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Sarabia Condés JM, Ibañez Martínez L, Sánchez Carrasco MA, Carrillo Julia FJ, Salmerón Martínez EL. Hamate fractures. Rev Esp Cir Ortop Traumatol (Engl Ed) 2015; 59:299-306. [PMID: 25823609 DOI: 10.1016/j.recot.2015.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 09/19/2014] [Accepted: 02/06/2015] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The purpose of this paper is to present our experience in the treatment of the fractures of the hamate and to make a review of the literature on this topic. MATERIAL AND METHOD We retrospectively reviewed 10 patients treated in our clinic between 2005-2012 suffering from fractures of the hamate. Six cases were fractures of the body and four were fractures of the hamate. Five cases were of associated injuries. Diagnostic delay ranged from 30 days to 2 years. Patient follow-up ranged from 1 to 10 years. Patient satisfaction was evaluated using the DASH questionnaire. Five patients with a fracture of the body underwent surgery, and one was treated conservatively. Two patients with fracture of the hook of the hamate were treated with immobilization, and two more patients had the fragment removed. RESULTS The grip strength and the digital clip were reduced in 2 cases. Flexion and extension of the wrist was limited in 3 cases. The mobility of the fingers was normal in all the cases, except in one. The results obtained from the DASH questionnaire were normal in all the cases, except in one case of fracture of the hamate, and in two cases of fracture of the body. CONCLUSIONS The surgical treatment should reduce the dislocation and stabilize the injuries with osteosynthesis. The fractures of the hamate are usually diagnosed late, and the most recommended treatment is removal of the fragment, although it cannot be deduced from this study.
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Affiliation(s)
- J M Sarabia Condés
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Morales Meseguer, Murcia, España.
| | - L Ibañez Martínez
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Morales Meseguer, Murcia, España
| | - M A Sánchez Carrasco
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Morales Meseguer, Murcia, España
| | - F J Carrillo Julia
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Morales Meseguer, Murcia, España
| | - E L Salmerón Martínez
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Morales Meseguer, Murcia, España
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Gaillard J, Roy-Maillot S, Masmejean EH. Tendon rupture of the flexor digitorum profundus of the little finger secondary to hamate non-union. Chir Main 2015; 34:44-8. [PMID: 25600195 DOI: 10.1016/j.main.2014.10.147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 10/01/2014] [Accepted: 10/05/2014] [Indexed: 11/20/2022]
Abstract
Several cases of hamate fracture and non-union have been reported. The hook of the hamate acts as a pulley for the flexor tendons for the little and ring fingers. Hamate non-union is frequently associated with irritation of the adjacent soft tissues. We report the case of hamate non-union that was only detected because of a flexor digitorum profundus tendon rupture in the little finger, associated with tendinopathy of both flexor tendons of the ring finger.
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Abstract
We review different causes, diagnoses, and treatment options of closed flexor tendon disruptions in the hand. A classification of closed tendon ruptures based on their mechanism includes traumatic tendon avulsion, spontaneous midsubstance rupture, attrition rupture, infiltrative tenosynovial rupture, and iatrogenic. Certain conditions result in tendon disruption inflicted by more than 1 of these etiologies. In rheumatoid arthritis, tendon rupture may result from attrition on an exposed rough surface, proliferative tenosynovial tendon infiltration, or steroid use.
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Affiliation(s)
- David T Netscher
- Division of Plastic Surgery, Baylor College of Medicine, Houston, TX; Department of Orthopedics, Baylor College of Medicine, Houston, TX.
| | - Justin J Badal
- Division of Plastic Surgery, Baylor College of Medicine, Houston, TX; Department of Orthopedics, Baylor College of Medicine, Houston, TX
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24
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Abstract
Carpal fractures are uncommon, but if missed, can lead to morbidity and loss of function, especially in an athlete. Early diagnosis through physical examination, plain radiographs, and possibly advanced imaging is paramount. Treatment is specific to each fracture type, and return to play varies with each clinical scenario. This article organizes current knowledge of these potentially difficult fractures with a table of diagnoses and treatment guidelines.
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Affiliation(s)
- Ekaterina Y Urch
- Department of Hand, Upper Extremity and Microsurgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA
| | - Steve K Lee
- Department of Hand, Upper Extremity and Microsurgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA.
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25
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Mudgal CS, Klausmeyer MA. In reply:. J Hand Surg Am 2014; 39:176-7. [PMID: 24369952 DOI: 10.1016/j.jhsa.2013.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 11/09/2013] [Indexed: 02/02/2023]
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27
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Affiliation(s)
- Melissa A Klausmeyer
- Hand and Upper Extremity Service, Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, MA
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28
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Nho JH, Lee TK, Kim BS, Yoon HK, Gong HS, Suh YS. Closed rupture of flexor tendon by hyperextension mechanism in wrist level (zone V): a report of three cases. Arch Orthop Trauma Surg 2013; 133:1029-32. [PMID: 23604791 DOI: 10.1007/s00402-013-1757-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Indexed: 10/26/2022]
Abstract
Closed flexor tendon ruptures due to trauma without external wound are rare. When the flexor tendon has excessive loading, failure occurs at the tendon insertion or its origin from the bone. It is likely to result in avulsion fracture rather than rupture of the proper portion of the tendon by forceful grasping with hyperextension. However, we have experienced three cases of closed flexor tendon ruptures at zone V, caused by forceful grasping or hyperextension mechanism against resistance. On physical examination, these patients could not flex interphalangeal joint of thumb or distal interphalangeal joint of the fifth finger. All patients underwent MRI or ultrasonography to find out the location of loss in continuity of the flexor tendons before the operation. After identifying the location, flexor tendon repair or tendon graft using palmaris longus were performed.
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29
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Taleb C, Murachowsky J, Ruggiero GM. Hamate hook nonunion treated with a hook plate: case report and surgical technique. Tech Hand Up Extrem Surg 2012; 16:194-7. [PMID: 23160549 DOI: 10.1097/BTH.0b013e31826577f8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Despite of its rarity, hamate hook nonunion can cause several complications like tendon rupture or loss of grip strength. Admitted treatments in the literature are excision of the bone fragment or its open reduction and internal fixation. We report a clinical case of a high-level baseball player with hamate hook nonunion treated with an original technique of fixation using a hook plate.
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Abstract
Osseous injuries to the ulnar aspect of the carpus are increasing in frequency because of greater participation in sporting activities. Hamate body fractures are subdivided into coronal, sagittal oblique, proximal pole, and medial tuberosity fractures. Successful treatment of coronal fractures requires identification and treatment of associated disruption or instability of the ulnar 2 carpometacarpal joints. Displaced hamate hook fractures are optimally treated with early excision to avoid sequelae such as flexor tendon and nerve injury, and to allow early return to activity. Undisplaced pisiform fractures are managed nonoperatively, whereas displaced fractures and nonunions are treated by simple excision.
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31
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Jeong SH, Gu JH, Han SK, Kim WK. Two-staged tendon reconstruction in flexor tendon ruptures secondary to fracture of the hamate hook. Ann Plast Surg 2012; 69:157-60. [PMID: 21629053 DOI: 10.1097/SAP.0b013e31821ee401] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We report a case of 2-staged reconstruction of flexor tendons ruptured spontaneously by attrition. A 49-year-old man presented with inability to flex the ring and little fingers of his left hand. Preoperative computed tomographic scans revealed fracture of the hamate hook. At the time of the operation, both the flexor superficialis and profundus of the little finger and the flexor profundus tendon of the ring finger were ruptured adjacent to the fracture site of the hamate. Because the flexor tendon rupture secondary to the fracture of the hamate is extremely rare, and surgical outcomes of previous reports are not satisfactory, a decision was made to perform 2-staged reconstruction of ruptured flexor tendons. The surgical result was excellent with complete restoration of full range of motion. This report describes for the first time to our knowledge, the technique, and rehabilitation of 2-staged tendon reconstruction in a patient with hook of hamate fracture.
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32
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Abstract
The incidence of fractures of the hamate hook (hamulus) has been reported to be between 2% and 4% of all carpal fractures. Untreated hamulus nonunion can cause attritional rupture of the ulnar digits' flexor digitorum profundum tendons. Rupture of flexor tendons due to nonunion of the hook of the hamate is an uncommon injury. Most surgeons treat the tendon lesion by a graft, transfer of the superficial flexor of the ring finger, or terminolateral suture of the distal stump of the deep flexor tendon of the little finger to the deep flexor tendon of the ring finger. This article reports a case of a 52-year-old right-handed man who presented with weakness of grip and loss of active flexion of both distal and proximal interphalangeal joints of the right small finger lasting 2 weeks due to grip strength while working. The clinical history and the physical examination were dissonant, and a computed tomography scan revealed a nonunion of the hamulus. Intraoperatively, the nonunion of the hamate hook was identified and the bony ossicle excised. The flexor digitorum profundus and superficialis to the small finger were both ruptured. The flexor digitorum profundus tendon was repaired with a termino-terminal suture. The patient returned to work within 3 months without restriction. Six months postoperatively, the patient had no pain and achieved full active flexion of the small finger.
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Affiliation(s)
- Miguel Pajares-López
- Department of Orthopedic Surgery, San Cecilio University Hospital, Granada, Spain.
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33
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Abstract
The anatomy of the hand is complex, which allows for the dexterity, strength, and adaptability of the most functional aspect of the musculoskeletal system. The evaluation and management of injuries to this area can be time consuming and pose a significant medicolegal risk to the emergency physician. Improperly diagnosed and managed injuries can lead to chronic pain, inability to perform activities of daily living, and even seemingly minor injuries can lead to missed work causing a significant cost to the individual and society. The purpose of this article is to review injuries to the hand and wrist and discuss diagnostic studies and treatment plans that the emergency physician can use to treat patients effectively and minimize their exposure to risk.
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34
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Abstract
Closed tendon rupture is a well-known complication of Kienböck disease, but only 11 cases have been reported. We reviewed six cases of Kienböck disease with subcutaneous rupture of a tendon. There were five cases of 4th extensor tendons and one case of the flexor digitorum profundus tendons of the ring finger and little finger. Radiographs showed protrusion of the segmented lunate or the deformed lunate in all cases. Intraoperative findings confirmed rupture of the wrist joint capsule by these lunate lesions. We then reviewed 11 reported cases in English and 48 cases in Japanese and confirmed that all cases had similar clinical characteristics and radiological features to our own, except the involved digits of flexor tendon rupture. Our case was unique in that the ulnar side tendons were ruptured, while in the reported cases the radial flexor tendons were more susceptible to rupture than the ulnar ones. Closed rupture of tendons should be recognised as a complication in patients over middle age with stage IIIb or IV asymptomatic or less symptomatic Kienböck disease.
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Affiliation(s)
- Tomoyuki Niwa
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, Japan.
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35
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Abstract
Carpal bone fractures make up a significant proportion of injuries to the wrist. The complex bone shape and articulations make diagnosis more difficult and missed injuries more common. This article reviews carpal bone fractures excluding the scaphoid.
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Affiliation(s)
- Steven Papp
- Department of Orthopaedic Surgery, University of Ottawa, Ottawa Civic Hospital, Ottawa, Ontario, Canada K1Y 4E9.
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36
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Hattori Y, Doi K, Hoshino S, Sakamoto S, Yukata K. Attritional rupture of the flexor tendons to the small finger caused by osteophyte of the ulnar head: case report. J Hand Surg Am 2010; 35:24-6. [PMID: 20117305 DOI: 10.1016/j.jhsa.2009.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2009] [Revised: 09/05/2009] [Accepted: 09/10/2009] [Indexed: 02/02/2023]
Abstract
We present a rare case of attritional rupture of the flexor tendons to the small finger caused by an osteophyte of the volar aspect of the ulnar head.
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Affiliation(s)
- Yasunori Hattori
- Department of Orthopedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi, Japan.
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37
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Celi J, de Gautard G, Della Santa JD, Bianchi S. Sonographic diagnosis of a radiographically undiagnosed hook of the hamate fracture. J Ultrasound Med 2008; 27:1235-1239. [PMID: 18645083 DOI: 10.7863/jum.2008.27.8.1235] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Julien Celi
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Yamazaki H, Kato H, Hata Y, Nakatsuchi Y, Tsuchikane A. Closed rupture of the flexor tendons caused by carpal bone and joint disorders. J Hand Surg Eur Vol 2007; 32:649-53. [PMID: 17993426 DOI: 10.1016/j.jhse.2007.06.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2006] [Revised: 06/03/2007] [Accepted: 06/13/2007] [Indexed: 02/03/2023]
Abstract
We analysed 21 patients with closed rupture of the flexor tendons caused by carpal bone and joint disorders. The tendon that ruptured depended on the location of the bone perforation into the carpal tunnel. Radiocarpal arthrography was performed in 13 patients and capsular perforation was demonstrated by contrast medium leakage into the carpal canal in 11 patients. This proved a useful diagnostic test. The flexor tendon(s) were reconstructed with free tendon graft in 17 patients, cross-over transfer of flexor tendons from adjacent digits in two and buddying to an adjacent flexor tendon in one patient. Postoperative total active range of motion in the fingers after 13 free tendon graft reconstructions averaged 213 degrees (range 170-265 degrees ). The active range of motion of the thumb-interphalangeal joint after free tendon graft reconstruction in three cases improved from 0 degrees to 33 degrees on average (range 10 degrees -40 degrees ).
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Affiliation(s)
- H Yamazaki
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto City, Nagano, Japan.
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39
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Abstract
Carpal bone fractures make up a significant proportion of injuries to the wrist. The complex bone shape and articulations make diagnosis more difficult and missed injuries more common. This article reviews carpal bone fractures excluding the scaphoid.
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Affiliation(s)
- Steven Papp
- Department of Orthopaedic Surgery, University of Ottawa, Ottawa Civic Hospital, 1053 Carling Avenue, Ottawa, Ontario, Canada K1Y 4E9.
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