Treatment of the fracture of the hook of the hamate in golf.

概要

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We experienced 2 cases of the fracture of the hook of the hamate by a golf swing striking the ground. Both cases had been misdiagnosed as tenosynovitis, wrist sprain or Guyon's canal syndrome. Correct diagnosis was made 4 months (Case 1) and 2 months (Case 2) after injury by carpal tunnel X-ray view. Both fractures were seen at the base of the hook and showed no union on X-ray examination. They were treated by removal of the fragment by volar approach in the first case and lateral approach in the second case. In lateral approach, dissecting between the 5th metacarpal and the abductor digiti minimi muscle and retracting the deep branch of the ulnar nerve volarly with the opponens digiti minimi muscle, it is easy to approach the hook of the hamate and to expose the base of the fragment. Besides we stress in this paper that lateral approach is safer to ulnar nerve than volar one and operative scar is not left in the palm.