Dorsal fracture of the hamate: distinctive radiographic appearance

Department of Radiology, University of Florida, Gainesville 32610.

Six patients who injured their wrists had radiographs documenting a dorsal, 5- to 10-mm oblong fragment of bone immediately proximal to the base of the fourth and/or fifth metacarpal bones. The fragment was seen on the pronation oblique and/or lateral projections, but not on the posteroanterior projection. The radiographic appearance of the fragment was remarkably similar in all cases. In the one patient in which it was performed, pluridirectional tomography demonstrated that the fragment originated from the dorsal surface of the hamate. Five of the six patients also had associated posterior dislocation of the fourth and/or fifth metacarpals. We conclude that this fragment represents a coronal fracture through the body of the hamate resulting from posterior dislocation or subluxation of the fourth and/or fifth metacarpal.
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				Y. LIAW, G. KALNINS, G. KIRSH, and I. MEAKIN Combined Fourth and Fifth Metacarpal Fracture and Fifth Carpometacarpal Joint Dislocation J Hand Surg Eur Vol., April 1, 1995; 20(2): 249 - 252. [Abstract] [PDF]