Analysis of Wrist Morphology Through Hamate and Lunate Bone Variations in Anatolian Population Using Plain Radiography / Análisis de la Morfología de la Articulación Radiocarpiana a Través de las Variaciones de los Huesos Hamato y Semilunar en la Población de Anatolia Mediante Radiografía Simple

SUMMARY: The present study aimed to evaluate wrist (lunate) anatomy in terms of the incidence of lunatum morphology on plain-radiographs among the Anatolian (Turkey) population, accompanied by demographic analysis. We obtained all the patients' data regarding demographical features, diagnosis, and posteroanterior (PA) X-ray imaging. Two radiograph-reviewers repeated the analysis twice, one month later, blinded to their findings before the previous review. The lunatum structure was determined as Type-1 (n:293) and Type-2 (n:207) for each radiograph. Most of the 500 wrists' radiographs [n:293 (58.6 %)] were type-I lunate. The mean age was 36.7±13.3 (range:18-90) years. Sex distribution was as follows: 185 (63.1 %) males to 108 (36.9 %) females. Type-2 lunate was seen in 207 participants (41.4 %). The mean age for type-2 was 41.6±15.2 (18-88) years. 142 (68.6 %) participants were male sex, while 65 (31.4 %) were females. The mean age of subjects with type-I showed a difference with type-II (p=0.007). There was no relationship in terms of sex (p=0.206) between the groups. In the Anatolian region, type-1 lunate was dominant compared to type-2. The incidence rate of lunate type in Anatolian population was similar to the Arab population.

El presente estudio tuvo como objetivo evaluar la anatomía de la articulación radiocarpiana en términos de la incidencia de la morfología del hueso semilunar en radiografías simples entre la población de Anatolia (Turquía), acompañado de un análisis demográfico. Obtuvimos todos los datos de los pacientes con respecto a las características demográficas, el diagnóstico y las imágenes de rayos X posteroanteriores (PA). Dos revisores de radiografías repitieron el análisis dos veces, un mes después, sin conocer sus hallazgos antes de la revisión anterior. La estructura del lunatum se determinó como Tipo-1 (n:293) y Tipo-2 (n:207) para cada radiografía. La mayoría de las 500 radiografías de muñecas [n:293 (58,6 %)] fueron semilunar tipo I. La edad media fue de 36,7±13,3 (rango: 18-90) años. La distribución por sexos fue la siguiente: 185 (63,1 %) hombres y 108 (36,9 %) mujeres. El semilunar tipo 2 se observó en 207 participantes (41,4 %). La edad media para el tipo 2 fue de 41,6±15,2 (18-88) años. 142 (68,6 %) participantes eran del sexo masculino, mientras que 65 (31,4 %) eran del sexo femenino. La edad media de los sujetos con tipo I mostró una diferencia con el tipo II (p = 0,007). No hubo relación en cuanto al sexo (p=0,206) entre los grupos. En la región de Anatolia, el semilunar tipo 1 era dominante en comparación con el tipo 2. La tasa de incidencia del tipo semilunar en la población de Anatolia fue similar a la de la población árabe.

Non-union in a hook of hamate fracture of a skeletally immature baseball player.

An isolated hook of hamate fracture is an extremely rare condition in skeletally immature patients. Early diagnosis and treatment are vital for the functional outcome of athletes such as baseball players. The hook of hamate fracture may be missed at initial presentation due to nonspecific symptoms and false-negative radiographs, which may eventually lead to a nonunion. Currently, there is no clear indication of surgical intervention for nonunion of the hook of hamate in a skeletally immature patient. This report presents the case of a twelve-year-old skeletally immature male with a hook of hamate fracture who underwent surgical bone fragment excision three months after initial injury due to a nonunion of the hamate bone. At the two-year postoperative visit, excellent results were obtained, and patient was able to continue his sports activity without any functional impairment.

Reconstructive surgery of the amputated ring finger.

PURPOSE: Loss of a fourth digit below the level of the proximal phalanx results in a weakened grip, loss of skilled movements, and the amputation stump is repeatedly traumatized. Transposition of an adjacent fifth digital ray can improve hand function and cosmetic appearance by closing the gap created by the missing digit. Digital ray amputation is not a commonly performed procedure. However, when performed correctly it can dramatically improve hand function and cosmesis. The aim of this study was to evaluate the functional and aesthetic results of the fifth ray radial translation and intercarpal arthrodesis in mutilating ring finger injuries. MATERIALS AND METHODS: In this retrospective study, nine consecutive patients who sustained mutilating ring finger injury were managed by fourth ray amputation with fifth ray transposition between January 2008 and December 2014. There were six males and three females with a mean age of 30.2 ± 12.2 years (age range, 16-56 years) at the time of surgery who underwent delayed fourth ray amputation with fifth ray transposition (after 14 days of injury). Eight cases had undergone previous surgical interventions: three ORIF using intramedullary K-wire fixation, one failed reimplantation, four debridement and application of split thickness skin graft. Primary skin closure of the amputated finger was not considered as previous surgery (one patient). RESULTS: All patients were followed up for a mean period of 17.1 ± 4.1 months (range, 12-24 months). Grip strength and RAS score improved after fourth ray resection. The postoperative grip strength and RAS (score) were not compromised by the associated hand dominance. CONCLUSION: The following conclusions can be made despite the fact that this was a limited study as well as a retrospective analysis: 1-In technical terms, resection of the fourth ray with transposition of the small finger with a wedge-shaped hamate-capitate arthrodesis secured by screw fixation is easier than metacarpal osteotomy/transposition and less liable to post-operative complications. 2-The results of this study suggest that fourth ray resection and transposition of the small finger with a hamate-capitate arthrodesis restores hand function and cosmetics.

Fractura aislada del cuerpo del hueso ganchoso / Isolated fracture of the body of the hamate bone

Las fracturas del hueso ganchoso son muy poco frecuentes, constituyendo alrededor del 2% de todas las fracturas del carpo. Debido a su baja frecuencia y a lo inespecífico de las manifestaciones clínicas, su diagnóstico suele ser difícil. Es importante considerar su presencia ante un traumatismo directo sobre la mano. Debe estudiarse inicialmente con radiografía de mano. Si es necesario confirmar el diagnóstico o valorar las lesiones asociadas, se sugiere la tomografía axial computarizada. La decisión terapéutica depende del grado de conminución de la fractura, de su estabilidad y de la presencia de compromiso articular. Se presenta el caso de un varón de 19 años que sufrió fractura aislada del cuerpo del hueso ganchoso.

Fractures of the hamate bone are very infrequent, representing approximately 2% of the carpal fractures. Due to its infrequency and to the non-specificity of its clinical manifestations, they are usually difficult to diagnose. Is important to consider its presence when a direct trauma over hand occurs. Study should start with X ray of the hand. If necessary to confirm the diagnosis or assess associated lesions, computed tomography is suggested. The therapeutic management depends on the degree of comminution of the fracture, its stability and any joint involvement. We present a case of a 19 year old male who suffered an isolated fracture of the body of the hamate bone.

Pathology and therapeutic results in patients with intraosseous ganglia of the carpal bone / Patología y resultados terapéuticos en los pacientes con ganglión intraóseo del hueso carpiano

This study evaluated the pathology and therapeutic results of seven patients with intraosseous ganglia of the carpal bone. The mean age at the time of surgery was 27.6 years. The lesions were localized in the proximal carpal row in six patients and in the distal carpal row in only one. Surgical treatment was performed in all patients with good bone union. None had pain during activity or at rest and no recurrence had occurred. The intraosseous ganglia in four patients was of the idiopathic type, and in the other three patients was of the penetrating type. Although intraosseous ganglia of the carpal bone is reported as a rare disease, there were 159 cases in the literature. The pathology was intra- or extraosseous development, showing variation, but most cases were localized in the proximal carpal row.

Este estudio evaluó la patología y resultados terapéuticos de siete pacientes con ganglión intraóseo del hueso carpiano. La edad promedio en el momento de la cirugía fue 27.6 años. Las lesiones se localizaban en la fila proximal del carpo en seis pacientes y en la fila distal carpiana solamente en uno. El tratamiento quirúrgico se realizó en todos los pacientes con buena unión ósea. Ninguno tuvo dolor durante la actividad o el reposo, y no había tenido lugar recurrencia alguna. El ganglión intraóseo en cuatro pacientes fue de tipo idiopático, y en los otros tres pacientes fue de tipo penetrante. Aunque el ganglión intraóseo del hueso carpiano se informa como una enfermedad rara, se reportaban 159 casos en la literatura. La patología consistía en un desarrollo intra- o extraóseo, con variación, pero la mayoría de los casos se localizaban en la fila proximal carpiana.

Fratura de stress do gancho do hamato: relato de caso com ênfase aos achados de imagem / Stress fracture of hamate's hook: case report with emphasis to the imaging findings

As fraturas de stress do gancho do hamato estão geralmente associadas com atividades esportivas que utilizam tacos, raquetes e bastões. Devido à ausência de um trauma óbvio, o diagnóstico exige maior conhecimento desta lesão e alto índice de suspeição. Os autores relatam o caso de um jogador de golfe com fratura de stress do gancho do hamato, com diagnóstico e acompanhamento realizados por ressonância magnética e tomografia computadorizada multislice.

Stress fractures of the hook of the hamate are related to sports that use devices such as golf clubs, rackets and baseball bats. Because usually there is no history of obvious trauma, the diagnosis necessitates better knowledge of the lesion and high index of suspicion. The authors report a case of stress fracture of the hook of the hamate in a golf player with diagnosis and follow-updone with magnetic resonance and multislice computer tomography.