Hook of Hamate Fracture - Everything You Need To Know - Dr. Nabil Ebraheim скачать в хорошем качестве

Hook of Hamate Fracture - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s education animated video describing Hook of Hamate fractures. The hamate is one of the many carpal bones of the hand and wrist. The hamate bone is a triangular bone located in the distal carpal row situated on the ulnar side of the hand. The hamate is composed of a body and a hook. The ulnar nerve passes through the Guyon’s canal between the hamate and pisiform bones. The ulnar nerve can become injured by a fracture of the body (rare) or by a fracture of the hook (common) which may cause neuropathy of the ulnar nerve within the Guyon's canal. Hamate fractures are classified as either a hook fracture (common) or as a body fracture (Rare). Missing the fracture can lead to persistent pain from nonunion. Hamate hook fractures are most often seen in racquet, bat or club sports such as hockey and golf. Fractures of the hamate bone are difficult to diagnose, and routine x-rays may not show the fracture. Hook fractures of the hamate are best seen by carpal tunnel x-ray views. Rule out ossification center (os hamuli proprium). For hamate fractures CT scan is the best study. Clinical evaluation •Hypothenar pain •Pain and paresthesia of the ring and small finger from ulnar nerve compression in the Guyon’s canal. •May be weakness of the intrinsics (ulnar nerve compression in the Guyon’s canal) •Decreased grip strength. •The most common findings is pain and tenderness on the ulnar side of the wrist distal to the wrist joint. Pull test is recently described. The palm of the hand is placed into supination. The wrist is in full ulnar deviation. Fingers of the patient should be flexed. The examiner pulls on the ulnar two digits with the patient resisting the pull. A positive test with pain in the area of the hook indicated a fractured hook of hamate injury. Differential diagnosis Pisiform fracture Check the hamate hook for a fracture. F the ulnar side hook is normal, then check the pisiform bone. May need to get a CT scan. Treatment •Acute fracture: early immobilization for acute fractures for 4-6 weeks to avoid nonunion •Symptomatic nonunion of the hook of hamate: excision of the fracture fragment. ORIF is rare. Become a friend on facebook:   / drebraheim   Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund: https://www.utfoundation.org/foundati... Background music provided as a free download from YouTube Audio Library. Song Title: Every Step