Detaillierte Beitrags-Information
| Beitragstitel | Pin fixation of fractures of the hook of hamate with small diameter is a feasible option |
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| Beitragscode | P019 |
| Autoren | |
| Präsentationsform | Poster |
| Themengebiete |
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| Abstract |
Introduction The necessity for internal fixation of hook of hamate fractures is still discussed. To prevent pseudarthrosis with ongoing pain, weakness and potential degenerative changes of flexor tendons, closed reduction and screw fixation can be performed. We report about a young women who sustained a hook of hamate fracture, but the available headless compression screws exceeded the hook diameter. Methods The 23 year old woman suffered a mangling injury of her left arm by a quad bike. Beside a severe soft tissue injury, a forearm fracture and several non-displaced carpal injuries, a hook of hamate fracture was diagnosed (type 1 III according to Milch classification). CRIF was planned to prevent pseudarthrosis. The carpal tunnel view was used for pin positioning. Because of a small hook diameter the osteosynthesis was performed with an OrthoSorb® pin 1.3mm instead of a headless compression screw following a postoperative immobilization in a forearm cast for initially six weeks. Results Six weeks postoperative the CT scan showed advanced bone healing. Wrist immobilization was prolonged for eight weeks. After three months slight tenderness on the palmar aspect was still present. The clinical examination six months postoperatively showed no tenderness, a negative Pull-Test and a painfree patient, therefore no further CT scan was necessary. Conclusion CRIF of hook of hamate fractures with a resorbable pin is a feasible option, especially in cases where the available headless compression screws exceed the diameter of the hook of hamate. Because compression forces of a resorbable pin are limited, prolonged postoperative immobilization must be accepted. |