PMC5470060_01
(a) Oblique 30o X-ray of the injured wrist showing dislocation of the 4th and 5th metacarpals. (b) CT scan showing the fracture of the hamate body, (c) clinical photo of the wrist showing diffuse swelling over the lesser metacarpals, (d) anteroposterior intraoperative (C-arm) X-ray showing fixation of the hamate with 2 small screws and reduction of the CMC dislocation with 2 KW, (e, f) anteroposterior and oblique X-rays of the wrist at 18 months showing healing of the hamate and congruent hamatometacarpal joint and (g) clinical photos of the wrist showing good range of motion and grip at the latest follow up.
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F1
Radiographic evaluation included x-rays (anteroposterior, lateral and oblique views) and computed tomography scan, which clearly demonstrated a coronal fracture of the body of the hamate associated with fourth and fifth CMC dorsal dislocation (Figs. 1a-c). The ring and little finger CMC dislocation was reduced applying longitudinal traction with a volar displacing force to the fourth and fifth metacarpals and 2 KW were driven to the third metacarpal and capitate bone (Fig. 1d). At his last follow-up appointment 18 months post-surgery, the patient was asymptomatic with almost full range of wrist and finger motion and a Mayo wrist score of 90 points (Figs. 1e-g).